Balloon-Assisted Percutaneous Transhepatic Antegrade Embolization with 2-Octyl Cyanoacrylate for the Treatment of Isolated Gastric Varices with Large Gastrorenal Shunts

Figure 1

A 56-year-old woman suffering from recurrent upper gastrointestinal bleeding from gastric varices. (a) Direct portography showed gastric varices (white asterisk) from the short gastric vein (white arrow). (b) Angiography of the short gastric vein (white arrow) showed gastric varices (white asterisk) and GRS (black arrow) that drained into left renal vein. (c) A balloon catheter was inserted into the left renal vein (short black arrow) to decrease the blood flow of the GRS (black arrow), and cyanoacrylate was then injected into the varices through the catheter into the feeding vein (white arrow). (d) Direct portography performed immediately after embolotherapy showing the varices (black asterisk) and the feeding vessels (white arrow) were filled with cyanoacrylate. PV, portal vein; SV, splenic vein; LRV, left renal vein; IVC, inferior vena cava.

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