Emergency Plug-Assisted Retrograde Transvenous Obliteration (PARTO) for Active Bleeding from Ruptured Gastric Varices.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2025-02-01 DOI:10.1016/j.jvir.2025.01.049

Eunbyeol Ko, Jeongyeon Kim, Dong Il Gwon, Hee Ho Chu, Gun Ha Kim, Gi-Young Ko

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引用次数: 0

Abstract

Purpose: To evaluate the safety and efficacy of emergency plug-assisted retrograde transvenous obliteration (PARTO) for active bleeding from ruptured gastric varices (GVs).

Materials and methods: Twenty-one patients with active bleeding from ruptured GVs were included in this retrospective study. Ten (47.6%) patients showed life-threatening hemorrhage (systolic blood pressure < 90mmHg) just before emergency PARTO. All patients underwent emergency PARTO after initial insufficient endoscopic cyanoacrylate injection (n=9) or because endoscopic injection was not possible (n=12).

Results: Emergency PARTO was technically successful in all 21 patients. The mean fluoroscopic time was 30.8 minutes (range, 10-62 minutes). There were no procedure-related adverse events. Hemostasis was obtained in 20 of 21 (95.2%) patients immediately after PARTO. In 16 patients who underwent CT, complete thrombosis or obliteration of GVs and portosystemic shunt was observed. With the exception of one patient who underwent external transfer, 15 patients died within a mean of 196 days (range, 1-1111 days), while five remained alive for a mean of 38.9 months (range, 17.1-74.2 months). Seven died within 30 days due to ischemia-related multiorgan failure (n=5), hypovolemic shock (n=1), or rapid progression of hepatocellular carcinoma (HCC) (n=1). The causes of death in the remaining nine patients were bleeding from EVs (n=2), liver failure (n=2), and rapid progression of HCC (n=5). The median patient survival time was 47 days (95% confidence interval, 0‒124 days). There was no case of rebleeding or recurrence of GVs.

Conclusion: Emergency PARTO appears to be a fast, safe, and effective treatment option for patients with active bleeding from ruptured GVs.

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.