AIM:To evaluate whether intra-procedural conebeam computed tomography (CBCT) performed during modified balloon-occluded retrograde transvenous obliteration (mBRTO) can accurately determine technical success of complete variceal obliteration.
METHODS:From June 2012 to December 2014, 15 patients who received CBCT during mBRTO for treatment of portal hypertensive gastric variceal bleeding were retrospectively evaluated. Three-dimensional (3D) CBCT images were performed and evaluated prior to the end of the procedure, and these were further analyzed and compared to the pre-procedure contrast-enhanced computed tomography to determine the technical success of mBRTO including: Complete occlusion/obliteration of: (1) gastrorenal shunt (GRS); (2) gastric varices; and (3) Core tip: This is a retrospective study to evaluate the feasibility, usefulness and efficacy of cone-beam computed tomography (CBCT) in modified balloonoccluded retrograde transvenous obliteration (mBRTO) procedures including coil-assisted retrograde transvenous obliteration and plug-assisted retrograde transvenous oblitearation. With an intra-procedural three-dimensional CBCT, the technical success of mBRTO was determined prior to the completion of the procedure in 100% of cases. With CBCT, a complete anatomy of gastric varices including gastrorenal shunt, gastric varices, collaterals, afferent and efferent vessels were identified easily. The CBCT may improve the technical and clinical success of mBRTO procedures and potentially reduce additional procedure time and cost.Lee EW, So N, Chapman R, McWilliams JP, Loh CT, Busuttil RW, Kee ST. Usefulness of intra-procedural cone-beam computed tomography in modified balloon-occluded retrograde transvenous obliteration of gastric varices.