Abstract
We studied hemodynamics of supplying vessels, gastric varices, and outflowing vessels in 37 cases of solitary gastric varices based on the images of arterial portography (AP) or percutaneous transhepatic portography (PTP) and balloon occluded retrograde transvenous varicerography (BRTV). Supplying vessels were unidentified in 17 of 33 cases (51.5%) by BRTV and inconsistent in 17 of 31 (54.8%) on comparison of AP or PTP with BRTV. Examination of outflowing vessels, G-R shunt alone was found in 54.3% of patients by AP or PTP, while it was found in 22.2%, less than half of the result by AP or PTP, by BRTV. Visualization of outflowing vessels was inconsistent between AP or PTP and BRTV in only 8 of 32 cases (25.0%). In BRTV of gastric varices, stagnation of the contrast medium was observed in 13 (39.4%), gastric varices were imaged without stagnation in 11 (33.3%), and there was no image obtained in 9 (27.3%). Blockage of accessory outflowing vessels was attempted in 14 cases, and subsequent BRTV showed stagnation of contrast medium in gastric varices in 11 cases (78.6%) and images of gastric varices without stagnation were obtained in 3 cases (14.3%). It is concluded that BRTV is more important than AP or PTP, when balloon occluded retrograde transvenous obliteration (B-RTO) is considered for treatment of gastric varices.
