Three benefits of microcatheters for retrograde transvenous obliteration of gastric varices

Figure 4 Additional injection of the sclerosant. A: Fluoroscopic image obtained during the first balloon-occluded retrograde transvenous obliteration (BRTO) shows full opacification of the gastric varices and gastrorenal shunt; B: Fluoroscopic image obtained during the second BRTO (next day) shows partial opacification of the varices and shunt, suggesting residual varices (arrow) and thrombosis of the varices and shunt (arrowheads); C: Contrast-enhanced computed tomography (CE-CT) before BRTO shows large varices (asterisk); D: CE-CT after the first BRTO shows residual varices (arrow) in the lateral portion of the stomach. The microcatheter tip (circle) is in the gastrorenal shunt close to the varices; E: CE-CT after the second BRTO shows complete thrombosis of the varices (asterisk). The sclerosant with contrast medium (circle) is detected in the gastrorenal shunt; F: CE-CT 3 mo after BRTO shows complete disappearance of the varices; G: Endoscopy before BRTO shows bulky varices (asterisk); H: Endoscopy 3 mo after BRTO shows complete disappearance of the varices.