Hemodynamic changes after balloon occlusion of the splenic artery during balloon-occluded retrograde transvenous obliteration for gastric varices.

Objective: To elucidate changes in hemodynamics after balloon occlusion of the splenic artery during balloon-occluded retrograde transvenous obliteration (B-RTO).

Methods: In eight patients who had B-RTO for a gastric varix, the balloon-occluded venous pressure of the drainage vein was measured, and balloon-occluded retrograde venography (B-RTV) was performed with and without occlusion of the splenic artery during B-RTO. The pressure and the degrees of the variceal complex visualized on B-RTV were compared between those with and without occlusion of the splenic artery.

Results: In seven of the eight patients, balloon-occluded venous pressure of the drainage vein decreased after balloon occlusion of the splenic artery. A paired t test showed that the mean decrease from 21.88 mm Hg to 18.38 mm Hg was statistically significant (P = .0033). From findings of B-RTV, the variceal complex was more extensively visualized after occlusion of the splenic artery in seven of the eight patients.

Conclusions: Balloon occlusion of the splenic artery during B-RTO for gastric varices can produce changes in hemodynamics related to gastric varices and has the potential to prompt the sclerosing agent to distribute more extensively and evenly in the gastric varix.