Background. We evaluated the efficacy of emergency balloon-occluded retrograde transvenous obliteration (B-RTO) performed within 24h after initial hemostasi s for the prevention of rebleeding from ruptured gastric var...Background. We evaluated the efficacy of emergency balloon-occluded retrograde transvenous obliteration (B-RTO) performed within 24h after initial hemostasi s for the prevention of rebleeding from ruptured gastric varices. Methods. From December 1995 to March 2003, 11 patients who had undergone B-RTO within 24h aft er the control of gastric variceal bleeding at Maebashi Red Cross Hospital were investigated. They were followed up for complete eradication, recurrence of vari ces, and rebleeding. Efficacy was determined by endoscopic examination and compu ted tomography. Results. The 4 patients with acute bleeding from ruptured gastri c varices were treated with endoscopic therapy-endoscopic variceal ligation (EV L) in 2 patients, and clipping treatment in 2. Initial hemostasis was achieved i n all 4; the other 7 patients had already stopped bleeding at endoscopy. After h emostasis was achieved, emergency B-RTO was immediately performed within 24h an d was successful in all 11 patients. Ten (90.9%) of the 11 gastric varices were obliterated and the other 1 (9.1%) was diminished in size. During the mean fol low-up period of 1136 days, no rebleeding or recurrence as found. Four patients died during the follow-up period, but none died from variceal bleeding. Surviv al rates were 90.9%and 70.7%, respectively, at 1 year and 3 years. In 6 patien ts, development of esophageal varices appeared during the follow-up period, all of which were controlled by usual endoscopic therapy. No severe side effects we re found after the B-RTO treatment. Conclusions. Emergency B-RTO is an effecti ve treatment for the prevention of rebleeding from ruptured gastric varices.展开更多
文摘Background. We evaluated the efficacy of emergency balloon-occluded retrograde transvenous obliteration (B-RTO) performed within 24h after initial hemostasi s for the prevention of rebleeding from ruptured gastric varices. Methods. From December 1995 to March 2003, 11 patients who had undergone B-RTO within 24h aft er the control of gastric variceal bleeding at Maebashi Red Cross Hospital were investigated. They were followed up for complete eradication, recurrence of vari ces, and rebleeding. Efficacy was determined by endoscopic examination and compu ted tomography. Results. The 4 patients with acute bleeding from ruptured gastri c varices were treated with endoscopic therapy-endoscopic variceal ligation (EV L) in 2 patients, and clipping treatment in 2. Initial hemostasis was achieved i n all 4; the other 7 patients had already stopped bleeding at endoscopy. After h emostasis was achieved, emergency B-RTO was immediately performed within 24h an d was successful in all 11 patients. Ten (90.9%) of the 11 gastric varices were obliterated and the other 1 (9.1%) was diminished in size. During the mean fol low-up period of 1136 days, no rebleeding or recurrence as found. Four patients died during the follow-up period, but none died from variceal bleeding. Surviv al rates were 90.9%and 70.7%, respectively, at 1 year and 3 years. In 6 patien ts, development of esophageal varices appeared during the follow-up period, all of which were controlled by usual endoscopic therapy. No severe side effects we re found after the B-RTO treatment. Conclusions. Emergency B-RTO is an effecti ve treatment for the prevention of rebleeding from ruptured gastric varices.
