Document Detail


Development of thrombus in the major systemic and portal veins after balloon-occluded retrograde transvenous obliteration for treating gastric variceal bleeding: its frequency and outcome evaluation with CT.
MedLine Citation:
PMID:  18375297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Sung Ki Cho; Sung Wook Shin; Young Soo Do; Kwang Bo Park; Sung Wook Choo; Sam Soo Kim; In Wook Choo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  529-38     Citation Subset:  IM    
Affiliation:
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Kangnam-gu, Seoul 135-710, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Balloon Occlusion / adverse effects*
Esophageal and Gastric Varices / radiography,  therapy*
Female
Humans
Male
Middle Aged
Portal Vein*
Retrospective Studies
Tomography, X-Ray Computed*
Venous Thrombosis / etiology*,  radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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