Usefulness of intra-procedural cone-beam computed tomography in modified balloon-occluded retrograde transvenous obliteration of gastric varices

被引：5
作者：
Lee, Edward Wolfgang [1 ]
So, Naomi [1 ]
Chapman, Ryan [1 ]
McWilliams, Justin P. [1 ]
Loh, Christopher T. [1 ]
Busuttil, Ronald W. [2 ]
Kee, Stephen T. [1 ]
机构：
[1] Univ Calif Los Angeles, David Geffen Sch Med, Med Ctr, Div Intervent Radiol,Dept Radiol, 757 Westwood Plaza,Suite 2125, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dumont UCLA Transplant Ctr, Div Liver & Pancreas Transplantat,Dept Surg,Pfleg, Los Angeles, CA 90095 USA
来源：
WORLD JOURNAL OF RADIOLOGY | 2016年 / 8卷 / 04期
关键词：
Gastric varices; Modified balloon-occluded retrograde transvenous obliteration; Gastric variceal bleeding; Cone-beam computed tomography; Coil-assisted retrograde transvenous obliteration;
D O I：
10.4329/wjr.v8.i4.390
中图分类号：
R8 [特种医学]; R445 [影像诊断学];
学科分类号：
1002 ; 100207 ; 1009 ;
摘要：
AIM: To evaluate whether intra-procedural cone-beam computed tomography (CBCT) performed during modified balloon-occluded retrograde transvenous obliteration (mBRTO) can accurately determine technical success of complete variceal obliteration. METHODS: From June 2012 to December 2014, 15 patients who received CBCT during mBRTO for treatment of portal hypertensive gastric variceal bleeding were retrospectively evaluated. Three-dimensional (3D) CBCT images were performed and evaluated prior to the end of the procedure, and these were further analyzed and compared to the pre-procedure contrast-enhanced com-puted tomography to determine the technical success of mBRTO including: Complete occlusion/obliteration of: (1) gastrorenal shunt (GRS); (2) gastric varices; and (3) afferent feeding veins. Post-mBRTO contrast-enhanced CT was used to confirm the accuracy and diagnostic value of CBCT within 2-3 d. RESULTS: Intra-procedural 3D-CBCT images were 100% accurate in determining the technical success of mBRTO in all 15 cases. CBCT demonstrated complete occlusion/obliteration of GRS, gastric varices, collaterals and afferent feeding veins during mBRTO, which was confirmed with post-mBRTO CT. Two patients showed incomplete obliteration of gastric varices and feeding veins on CBCT, which therefore required additional gel-foam injections to complete the procedure. No patient required additional procedures or other interventions during their follow-up period (684 +/- 279 d). CONCLUSION: CBCT during mBRTO appears to accurately and immediately determine the technical success of mBRTO. This may improve the technical and clinical success/ outcome of mBRTO and reduce additional procedure time in the future.
引用
收藏
页码：390 / 396
页数：7
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