Balloon-occluded retrograde transvenous obliteration for treatment of gastric varices

Table 1 The studies comparing balloon-occluded retrograde transvenous obliteration and transjugular intrahepatic portosystemic shunt

Ref.	Journal	Country	Study design	Number of cases
				BRTO	TIPS
Choi et al[39]	KJR 2003	South Korea	RCT, Single institution	8	13
Ninoi et al[40]	AJR 2004	Japan	Retrospective, Single institution	77 (BRTO: 49 / PTS: 28)	27
Sabri et al[41]	JVIR 2014	United States	Retrospective, Single institution	23	27
Kim et al[42]	KJR 2017	United States	Retrospective, Single institution	25	27
Lee et al[43]	JGH 2017	South Korea	Retrospective, Two institutions	95	47
Gimm et al[44]	Gut and Liver 2018	South Korea	Retrospective, Single institution	157	19

BRTO: Balloon-occluded retrograde transvenous obliteration; TIPS: Transjugular intrahepatic portosystemic shunt; RCT: Randomized controlled trial; PTS: Percutaneous transhepatic sclerotherapy.

Table 2 Materials used and technical success rate

Ref.	BRTO	Tips	Technical success rate
	sclerosant	Stent type	BRTO	TIPS
Choi et al[39]	EO	Bare	8/8	13/13
Ninoi et al[40]	EO	Bare	49/58	27/27
Sabri et al[41]	STS	Covered	21/23	27/27
Kim et al[42]	EO, STS	Covered	22/25	27/27
Lee et al[43]	EO, STS, polidocanol	Covered	106/123	49/60
Gimm et al[44]	EO, STS	Bare, covered	159/166	19/22
Total			365/403	162/176
			90.6%1	92.0%1

¹Not significant. BRTO: Balloon-occluded retrograde transvenous obliteration; TIPS: Transjugular intrahepatic portosystemic shunt; EO: Ethanolamine oleate, STS: Sodium tetradecyl sulfate.

Table 3 Rebleeding rate from gastric varices and esophageal varices

Ref.	Rebleeding rate from GVs		Rebleeding rate from EVs
	BRTO	TIPS	BRTO	TIPS
Choi et al[39]	0/8	1/13	0/8	0/13
Ninoi et al[40]	1/77	6/27	3/77	2/27
Sabri et al[41]	0/23	3/27	0/23	0/27
Kim et al[42]	2/25	2/27	1/25	0/27
Lee et al[43]	7/95	6/47	4/95	7/47
Gimm et al[44]	8/157	3/19
Total	18/385	21/160	8/228	9/141
	4.7%1	13.1%1	3.5%2	6.4%2

¹P = 0.0005.

²Not significant. GVs: Gastric varices; EVs: Esophageal varices; BRTO: Balloon-occluded retrograde transvenous obliteration; TIPS: Transjugular intrahepatic portosystemic shunt.

Table 4 Complications after balloon-occluded retrograde transvenous obliteration or transjugular intrahepatic portosystemic shunt

Ref.	LF		HE		Ascites		EVs aggravation
	BRTO	TIPS	BRTO	TIPS	BRTO	TIPS	BRTO	TIPS
Choi et al[39]	0/8	1/13	0/8	1/13	0/8	0/13	1/8	0/13
Ninoi et al[40]	3/771	10/271	0/77	5/27	6/77		14/77
Sabri et al[41]	0/23	0/27	0/23	6/27
Kim et al[42]	0/25	0/27	0/25	6/27	1/25	1/27	1/25	0/27
Lee et al[43]	0/95	1/47	0/95	14/47	13/95	2/47
Gimm et al[44]	0/157	0/19	4/157	0/19	48/157	1/19	22/157	1/19

¹Including long-term events. BRTO: Balloon-occluded retrograde transvenous obliteration; TIPS: Transjugular intrahepatic portosystemic shunt; LF: Liver failure; HE: Hepatic encephalopathy; EVs: Esophageal varices.