Gastric Varices (CARTO/BRTO/PARTO)

Codeholic Admin — Mon, 13 Mar 2017 16:37:15 +0000

Gastric Varices (CARTO/BRTO/PARTO)

Gastric Varices

Varices are dilated vessels which may rupture, causing variceal bleeding. Gastric variceal bleeding describes the bleeding that occurs when dilated vessels in the stomach rupture, and is associated with high morbidity and mortality rates. One of the major possible complications of portal hypertension is gastric variceal bleeding; portal hypertension refers to high blood pressure in the liver. BRTO/CARTO/PARTO are minimally invasive techniques used to treat gastric variceal bleeding.

Balloon-occluded retrograde transvenous obliteration (BRTO)

Coil-assisted retrograde transvenous obliteration (CARTO)

Plug-assisted retrograde transvenous obliteration (PARTO)

What is retrograde transvenous obliteration?

The procedure involves blocking the dilated vessels, reducing the risk of rupture. It can be used in addition to or as an alternative to TIPS, which is the primary treatment for gastric varices. TIPS aims to relieve the pressure on the dilated vessels by creating new connections between blood vessels in the liver using a shunt.

How does the procedure work?

The interventional radiologist will insert a catheter (a thin, flexible tube with a tiny balloon at one end) through a vein in your thigh or neck and guide the catheter to the liver using fluoroscopyfor guidance. The catheter is then directed to the gastrorenal or gastrocaval shunt and the blood flow is blocked.

The interventional radiologist will then perform a venography, which is a type of imaging technique in which X-rays are used to see the vessels clearly. This will allow the interventional radiologist to confirm exactly which vessels need to be treated and if there are any other abnormal or dilated vessels which have not previously been identified. A medication will then be injected into the dilated vessels through the catheter, until they are completely filled.

Another venography will then be performed, to confirm that the blood flow in the shunt has stopped.

Why perform it?

You may be advised to undergo this procedure if you are at risk of or already have gastric variceal bleeding and hepatic encephalopathy as well as a gastrorenal shunt. Hepatic encephalopathy refers to the worsening of brain function that is caused by a damaged liver.

The above information is not all inclusive of the risks, alternatives and benefits. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion. There are complications possible with any medical procedure. Overall, minimally invasive procedures have a lower complication rate than open surgeries.

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Gastric Varices (CARTO/BRTO/PARTO)