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Interventions for Portal Hypertension: BRTO and PARTO

  • Nishant Singla
  • Amar Mukund
Chapter
  • 39 Downloads

Abstract

Balloon occluded Retrograde Transvenous Obliteration (BRTO) and Plug-Assisted Retrograde Transvenous Obliteration (PARTO) are endovascular interventional procedure performed for the management of bleeding gastric varices and hepatic encephalopathy (HE) in patients with portal hypertension, particularly those with prominent infra-diaphragmatic portosystemic venous shunts (e.g., gastrorenal and gastro-caval shunts). These techniques are used either as a first-line treatment for gastric variceal hemorrhage in patients with cirrhosis having gastro-lienorenal shunt with failed endoscopic intervention or in patients with a contraindication for TIPS (Transjugular intrahepatic portosystemic shunt). Cirrhotic patients having refractory HE secondary to portosystemic shunts requiring multiple hospital admission may benefit from BRTO/PARTO.

Abbreviations

BRTO

Balloon-occluded retrograde transvenous obliteration

PARTO

Plug-Assisted Retrograde Transvenous Obliteration

TIPS

Transjugular intrahepatic portosystemic shunt

HE

Hepatic encephalopathy

STS

Sodium tetradecyl sulfate

PVT

Portal vein thrombosis

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Copyright information

© Springer Nature Singapore Pte Ltd. 2021

Authors and Affiliations

  • Nishant Singla
    • 1
  • Amar Mukund
    • 2
  1. 1.Interventional RadiologySarvodaya Hospital and Research CentreFaridabadIndia
  2. 2.Interventional RadiologyInstitute of Liver and Biliary SciencesNew DelhiIndia

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