TY - JOUR
T1 - Balloon-occlusion catheter rupture during balloon-occluded retrograde transvenous obliteration of gastric varices utilizing sodium tetradecyl sulfate
T2 - Incidence and consequences
AU - Saad, Wael E.A.
AU - Nicholson, David
AU - Lippert, Allison
AU - Wagner, Cynthia
AU - Turba, Cenk U.
AU - Sabri, Saher S.
AU - Davies, Mark G.
AU - Matsumoto, Alan H.
AU - Angle, John
PY - 2012/11
Y1 - 2012/11
N2 - Balloon-occluded retrograde transvenous obliteration (BRTO) is an established procedure for the management of bleeding gastric varices in Asia. Invariably, the sclerosant utilized in Asia is ethanolamine oleate and the inventory used (vascular sheaths, balloon-occlusion catheters, and microcatheters) is not available outside Asia. A total of 41 BRTO procedures were performed with a technical and obliterative (gastric varix obliteration) success rate of 95% (n = 39 of 41) and 85% (n = 35 of 41), respectively. Complications were 4.9% (n = 2/41). A total of 6 balloon ruptures occurred (14.6%, n = 6 of 41). One rupture (16.7%, n = 1 of 6 of ruptures) lead to a technical failure and 2 ruptures (33.3%, n = 2 of 6 of ruptures) lead to an obliterative failure. Balloon rupture contributed to 50% of technical failures (n = 1/2, P =.274) and 33% of obliteration failures (n = 2/6, P =.148). In conclusion, the incidence of balloon-occlusion catheter rupture utilizing 3% sodium tetradecyl sulfate (STS) and inventory unique to the United States is significantly higher than in Asia (<8% rupture rate). However, these ruptures have no significant technical or clinical consequences.
AB - Balloon-occluded retrograde transvenous obliteration (BRTO) is an established procedure for the management of bleeding gastric varices in Asia. Invariably, the sclerosant utilized in Asia is ethanolamine oleate and the inventory used (vascular sheaths, balloon-occlusion catheters, and microcatheters) is not available outside Asia. A total of 41 BRTO procedures were performed with a technical and obliterative (gastric varix obliteration) success rate of 95% (n = 39 of 41) and 85% (n = 35 of 41), respectively. Complications were 4.9% (n = 2/41). A total of 6 balloon ruptures occurred (14.6%, n = 6 of 41). One rupture (16.7%, n = 1 of 6 of ruptures) lead to a technical failure and 2 ruptures (33.3%, n = 2 of 6 of ruptures) lead to an obliterative failure. Balloon rupture contributed to 50% of technical failures (n = 1/2, P =.274) and 33% of obliteration failures (n = 2/6, P =.148). In conclusion, the incidence of balloon-occlusion catheter rupture utilizing 3% sodium tetradecyl sulfate (STS) and inventory unique to the United States is significantly higher than in Asia (<8% rupture rate). However, these ruptures have no significant technical or clinical consequences.
KW - balloon-occluded retrograde transvenous obliteration
KW - clinical practice
KW - varices
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UR - http://www.scopus.com/inward/citedby.url?scp=84866862515&partnerID=8YFLogxK
U2 - 10.1177/1538574412460769
DO - 10.1177/1538574412460769
M3 - Article
C2 - 23064824
AN - SCOPUS:84866862515
VL - 46
SP - 664
EP - 670
JO - Vascular and Endovascular Surgery
JF - Vascular and Endovascular Surgery
SN - 1538-5744
IS - 8
ER -