-
[show abstract]
[hide abstract]
ABSTRACT: To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled.
Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein.
In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus.
Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.
Korean journal of radiology: official journal of the Korean Radiological Society 05/2012; 13(3):324-31. · 1.32 Impact Factor
-
Koichi Soga,
Koichi Tomikashi,
Kohei Fukumoto,
Ki-Ichirou Miyawaki, Kotaro Okuda,
Hideyuki Konishi,
Nobuaki Yagi,
Naoki Wakabayashi,
Satoshi Kokura,
Yuji Naito,
Toshikazu Yoshikawa
[show abstract]
[hide abstract]
ABSTRACT: A 75-year-old man with general malaise and appetite loss was transferred to our hospital for assessment and treatment of liver failure. Laboratory findings on admission showed anemia, and gastroduodenoscopy (GDS) revealed linear esophageal varices and tensive duodenal varices (DV) in the second portion of the duodenum. Systemic examinations did not reveal any significant lesion capable of explaining his anemia, except for DV. Balloon-occluded retrograde transvenous obliteration was carried out to prevent DV bleeding. Good pooling of sclerosant was observed using two balloon catheters. However, contrast-enhanced computed tomography after the procedure revealed no thrombosis in DV, and the patient complained of tarry stools before additional therapy. Emergent GDS revealed ruptured DV with fresh blood and erosions on the surface. Emergent endoscopic obliteration using the tissue adhesive N-butyl-2-cyanoacrylate was carried out and complete hemostasis was achieved. Although no rebleeding episodes were observed after emergent obliteration, the patient died of sepsis following spontaneous bacterial peritonitis 53 days after admission. Autopsy revealed that DV dropped out, and the deep vein was replaced by granulation tissue. No signs of thrombi were detected, except varices. This autopsy case revealed the difficulty in DV management.
Digestive Endoscopy 10/2010; 22(4):329-33. · 1.19 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We encountered a case of gastric varix without a gastrorenal shunt that drained through the left pericardiacophrenic vein, which entered the left brachiocephalic vein. For this case we successfully performed balloon occluded retrograde transvenous obliteration, in which sclerotic agents were infused via the left pericardiacophrenic vein approached from the left subclavian vein.
CardioVascular and Interventional Radiology 04/2010; 34 Suppl 2:S206-9. · 2.09 Impact Factor
-
Koichi Soga,
Koichi Tomikashi,
Ki-ichiro Miyawaki, Kotaro Okuda,
Yusuke Sugiyama,
Shuji Sekikawa,
Naoki Wakabayashi,
Hideyuki Konishi,
Shoji Mitsufuji,
Keisho Kataoka,
Toshikazu Yoshikawa
Digestive Diseases and Sciences 10/2008; 54(7):1592-6. · 2.12 Impact Factor
