Balloon-occluded retrograde transvenous obliteration

Balloon-occluded retrograde transvenous obliteration (B-RTO) is a medical procedure used primarily in the treatment of gastroesophageal varices. This technique was first developed in Japan in the 1980s and has since been adopted worldwide due to its high success rate and low complication rate.

Procedure

The B-RTO procedure involves the use of a balloon catheter to occlude a vein and a sclerosing agent to obliterate the varices. The procedure is performed under fluoroscopic guidance to ensure accurate placement of the catheter and sclerosing agent. The balloon is inflated to occlude the vein, and the sclerosing agent is then injected retrograde into the varices. This causes the varices to shrink and eventually disappear.

Indications

B-RTO is primarily indicated for the treatment of gastroesophageal varices that are refractory to other treatments, such as endoscopic band ligation and pharmacotherapy. It may also be used in patients with portal hypertension who are not candidates for surgical shunting.

Complications

While B-RTO is generally considered safe, complications can occur. These may include hemorrhage, infection, thrombosis, and pulmonary embolism. However, these complications are rare and can usually be managed effectively.

Efficacy

Numerous studies have demonstrated the efficacy of B-RTO in the treatment of gastroesophageal varices. It has been shown to be highly effective in obliterating varices and preventing rebleeding, with success rates often exceeding 90%.

See also

• Gastroesophageal varices
• Portal hypertension
• Endoscopic band ligation