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

Figure 2

A 65-year-old man suffering from gastric variceal bleeding and encephalopathy. (a) Direct portography showed gastric varices (white asterisk) from the short gastric vein (white arrow) with drainage into the left renal vein through a large GRS (black arrow). (b) A balloon catheter (short white arrow) was introduced into the GRS (black arrow) through the femoral vein, and cyanoacrylate was directly infused into the gastric varices (white asterisk) from the catheter (white arrow) into the posterior gastric vein. (c) Before removal, the balloon catheter (short white arrow) was inflated in place for 1 min until the gastric varices (white asterisk) and the feeding vessels (white arrow) were completely obliterated by the cyanoacrylate. (d) Direct portography performed immediately after the embolotherapy showed the gastric varices (black asterisk) and the feeding vessels (white arrow) were filled with cyanoacrylate. PV, portal vein; SV, splenic vein; LRV, left renal vein.

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