Purpose

To investigate the technical feasibility, safety and clinical outcomes of coil-assisted retrograde transvenous obliteration II (CARTO-II) for gastric varices (GV).

Materials and Methods

Thirty-six consecutive patients who had undergone CARTO-II between June 2016 and April 2018 were included in the study. In the CARTO procedure, coil embolization of the drainage vein is performed “before” injection of the sclerosant to replace the use of balloon catheter. In the CARTO-II procedure, coil embolization of the drainage vein was performed “after” injection of the sclerosant to prevent migration of the sclerosant. CARTO-II was performed with ethanolamine oleate iopamidol, and the balloon catheter was immediately removed after coil placement. Technical and clinical success rates, number of coils used, presence or absence of severe complications, timing of the procedure, and rate of GV recurrence after the procedure were analyzed retrospectively.

Results

In all patients, GV sclerosis, coil placement and removal of the balloon catheter were successfully completed. The technical success rate was 100%. No patients experienced severe complications such as coil migration or pulmonary embolization. The mean number of metallic coils used per procedure was 3.36. Mean length of the procedure was 132.8 min. Contrast-enhanced computed tomography after CARTO-II confirmed complete variceal thrombosis in all cases. The recurrence rate of GV during follow-up was 2.8% (mean follow-up, 207 days).

Conclusion

CARTO-II was feasible and safe and could be performed relatively quickly. The number of coils used and the rate of GV recurrence were both low. CARTO-II may have an important role to play in the management of GV.

中文翻译：

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线圈辅助逆行静脉闭塞II（CARTO-II）在胃静脉曲张治疗中的应用

目的

目的探讨用于胃底静脉曲张（GV）的线圈辅助逆行静脉闭塞II（CARTO-II）的技术可行性，安全性和临床效果。

材料和方法

该研究纳入了2016年6月至2018年4月间接受CARTO-II治疗的连续36例患者。在CARTO程序中，在注入硬化剂之前，应先进行引流静脉的线圈栓塞术，以取代使用球囊导管。在CARTO-II程序中，在注入硬化剂之后“进行”引流静脉的线圈栓塞术，以防止硬化剂迁移。CARTO-II用乙醇胺油酸酯碘帕醇进行，放置线圈后立即取下球囊导管。回顾性分析技术和临床成功率，使用的线圈数量，是否存在严重并发症，手术时机以及手术后GV复发率。

结果

在所有患者中，GV硬化，线圈放置和球囊导管的移除均已成功完成。技术成功率为100％。没有患者经历过严重的并发症，例如线圈移位或肺栓塞。每个程序使用的金属线圈的平均数量为3.36。该过程的平均时间为132.8分钟。在所有病例中，CARTO-II证实完全静脉曲张性血栓形成后，造影增强CT扫描结果。随访期间GV的复发率为2.8％（平均随访207天）。

结论

CARTO-II既可行又安全，可以相对快速地进行。使用的线圈数量和GV复发率均较低。CARTO-II可能在GV的管理中发挥重要作用。