Balloon-occluded retrograde transvenous obliteration in patients with liver cirrhosis and variceal transformation of gastric veins: first experiences of Botkin hospital

Abstract

Aim. To analyze first experiences and demonstrate the results of balloon-occluded retrograde transvenous obliteration in patients with liver cirrhosis and variceal transformation of the gastric veins.Materials and methods. In the period from November 2023 to August 2024, balloon-occluded retrograde transvenous obliteration was performed on six male patients with liver cirrhosis and gastric varices for secondary prevention of bleeding. The mean age of the patients comprised 56.5 years. Significant gastrorenal shunt and predominantly right-sided drainage of gastroesophageal varices were considered technical indications for the procedure.Results. No fatalities or complications necessitating reoperation were reported. The follow-up period revealed no recurrences of bleeding. The overall survival rate over six months comprised 100%. Progression of gastric varices was noted in two out of six patients: one patient underwent a repeat procedure, while the other underwent liver transplantation.Conclusion. Balloon-occluded retrograde transvenous obliteration is recognized as a safe and effective radiological intervention for addressing complications associated with portal hypertension. However, it obtains several limitations and potential adverse effects, which necessitate careful monitoring during follow-up.