The Prevalence, Risk Factors, and Clinical Outcome of Balloon Rupture in Balloon-occluded Retrograde Transvenous Obliteration of Gastric Varices
Received 17 April 2009; received in revised form 19 November 2009; accepted 30 November 2009. published online 22 February 2010.
Purpose
To evaluate the prevalence, risk factors, and clinical outcome after balloon rupture during balloon-occluded retrograde transvenous obliteration (BRTO).
Materials and Methods
Sixty-nine patients who underwent the BRTO procedure from August 1999 to January 2009 were analyzed retrospectively. The occurrence of balloon rupture was recorded by a review of medical records and imaging studies. The χ2 test was used to analyze risk factors for balloon rupture including balloon type and size, amount of sclerosant, and the use of microcatheters. The influence of balloon rupture on migration of the sclerosant and in-hospital mortality was analyzed with the Fisher exact test.
Results
The prevalence of balloon rupture was 8.7% (six of 69 patients). No significant risk factor for balloon rupture was identified because of the small number of balloon rupture cases. Migration of the sclerosant occurred in three patients with early balloon rupture within 1 hour. One of these patients died of recurrent gastric variceal bleeding and another experienced dyspnea and died of fungal sepsis. Among the 63 patients without rupture, no migration of the sclerosant was noted, and one patient died of sepsis caused by liver abscess. Incidences of sclerosant migration and in-hospital mortality were significantly higher in patients with balloon rupture versus patients without balloon rupture (P = .018 and P < .001, respectively).
Conclusions
Balloon rupture during BRTO occurred in 8.7% of patients. Balloon rupture may cause rapid migration of sclerosant, pulmonary embolism, and recurrent gastric variceal bleeding.
Department of Radiology, Seoul National University College of Medicine; Institute of Radiation Medicine, Seoul National University Medical Research Center; and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
Address correspondence to J.W.C., Department of Radiology, Seoul National University Hospital, #28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
None of the authors have identified a conflict of interest.
ABSTRACT