Balloon-occluded retrograde transvenous obliteration with lauromacrogol sclerosant foam for gastric varices

Abstract

Objectives

To evaluate the safety and efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) using lauromacrogol sclerosant foam for gastric varices (GVs) with gastrorenal venous shunts.

Methods

Data of GV patients treated with BRTO using lauromacrogol sclerosant foam in 2016–2020 were retrospectively analyzed along with procedural success rate, complications, and follow-up efficacy.

Results

A total of 31 patients were treated with BRTO. The sclerosant foam was prepared by mixing iodinated oil, lauromacrogol, and air at a 1:2:3 ratio. The BRTO procedure was successfully completed in 93.5% of patients. One patient was allergic to the lauromacrogol injection. A mild postoperative fever occurred in three patients. One patient experienced grand mal seizures after the procedure. There was no significant difference in the median Child-Turcotte-Pugh scores before versus after BRTO. Complete GV resolution was observed in 93.1% of patients. One patient underwent endoscopic treatment for the development of high-risk esophageal varices. Another patient underwent transjugular intrahepatic portosystemic shunt placement for the aggravation of ascites.

Conclusions

Lauromacrogol sclerosant foam is safe and effective in patients undergoing BRTO for GV.