PURPOSE: To investigate the frequency and outcome of the thrombus that developed in the major systemic and portal veins after balloon-occluded retrograde transvenous obliteration (BRTO) by comparing the computed tomographic (CT) scans obtained before and after BRTO treatment. MATERIALS AND METHODS: Sixty patients with liver cirrhosis who underwent BRTO to treat gastric variceal bleeding were included in this study. The pre- and postprocedural CT scans in these patients were retrospectively compared to evaluate thrombus development in the major systemic and portal veins after BRTO. Thrombus was classified as having a high attenuation (ie, containing iodized oil), combined attenuation, or low attenuation. The outcome of the thrombus that developed in those veins after BRTO was evaluated by reviewing the serial follow-up CT scans. RESULTS: After BRTO, 14 thrombi developed in 13 systemic and portal veins of nine of the 60 patients (15%). Eleven of the 14 thrombi had high attenuation, two thrombi had low attenuation, and one thrombus had a combined attenuation. The 13 affected veins included six splenic veins, four left renal veins, and three main portal veins. On the serial follow-up CT scans (range of the follow-up period, 5-25 months), all 11 high-attenuation thrombi were completely resolved without sequelae in the affected veins. One of the two low-attenuation thrombi disappeared with severe slitlike collapse of the affected left renal vein; the other low-attenuation thrombus had progressed and it caused complete occlusion of the affected main portal vein. One thrombus with a combined attenuation was almost completely resolved without sequelae in the affected splenic vein, despite the transient enlargement of the low-attenuation component. CONCLUSIONS: In this study, the frequency of thrombus development in the major systemic and portal veins after BRTO was 15%. Although iodized oil deposited in those veins appears to be of no great importance, the low-attenuation thrombus can be associated with occlusion of the affected vein. These tendencies, however, require validation in a larger series.
PURPOSE: To investigate the frequency and outcome of the thrombus that developed in the major systemic and portal veins after balloon-occluded retrograde transvenous obliteration (BRTO) by comparing the computed tomographic (CT) scans obtained before and after BRTO treatment. MATERIALS AND METHODS: Sixty patients with liver cirrhosis who underwent BRTO to treat gastric variceal bleeding were included in this study. The pre- and postprocedural CT scans in these patients were retrospectively compared to evaluate thrombus development in the major systemic and portal veins after BRTO. Thrombus was classified as having a high attenuation (ie, containing iodized oil), combined attenuation, or low attenuation. The outcome of the thrombus that developed in those veins after BRTO was evaluated by reviewing the serial follow-up CT scans. RESULTS: After BRTO, 14 thrombi developed in 13 systemic and portal veins of nine of the 60 patients (15%). Eleven of the 14 thrombi had high attenuation, two thrombi had low attenuation, and one thrombus had a combined attenuation. The 13 affected veins included six splenic veins, four left renal veins, and three main portal veins. On the serial follow-up CT scans (range of the follow-up period, 5-25 months), all 11 high-attenuation thrombi were completely resolved without sequelae in the affected veins. One of the two low-attenuation thrombi disappeared with severe slitlike collapse of the affected left renal vein; the other low-attenuation thrombus had progressed and it caused complete occlusion of the affected main portal vein. One thrombus with a combined attenuation was almost completely resolved without sequelae in the affected splenic vein, despite the transient enlargement of the low-attenuation component. CONCLUSIONS: In this study, the frequency of thrombus development in the major systemic and portal veins after BRTO was 15%. Although iodized oil deposited in those veins appears to be of no great importance, the low-attenuation thrombus can be associated with occlusion of the affected vein. These tendencies, however, require validation in a larger series.
Authors: Edward W Lee; Sammy Saab; Antoinette S Gomes; Ronald Busuttil; Justin McWilliams; Francisco Durazo; Steven-Huy Han; Leonard Goldstein; Bashir A Tafti; John Moriarty; Christopher T Loh; Stephen T Kee Journal: Clin Transl Gastroenterol Date: 2014-10-02 Impact factor: 4.488
Authors: Yiming Zhao; Shufang Wang; Congyong Li; Liangliang Guo; Chao Li; Li Zhao; Le Tian; Siyang Zheng; Jiangtao Liu; Gang Sun Journal: Medicine (Baltimore) Date: 2020-04 Impact factor: 1.817