Feasibility and Effectiveness of Cyanoacrylate-Assisted Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices and Splenorenal Shunts.

PURPOSE: To evaluate the technical feasibility and clinical effectiveness of cyanoacrylate-assisted balloon-occluded retrograde transvenous obliteration (Cya-BRTO) for gastric varices (GVs) and splenorenal shunts (SRSs).

MATERIALS AND

METHODS

This retrospective study included 23 patients who underwent Cya-BRTO between November 2021 and May 2025. Cases involving combined transjugular intrahepatic portosystemic shunt or antegrade transvenous obliteration were excluded. Primary endpoints were technical success rate and obliteration rate of the GVs or SRS, with the latter evaluated by contrast-enhanced computed tomography (CT) and/or endoscopy.

RESULTS

The technical success rate of Cya-BRTO was 100% (23/23), with all patients achieving the intended therapeutic goals. The complete obliteration rate for GVs or SRS was 91.30% (21/23). Immediate balloon catheter removal was achieved in all patients. The mean postoperative hospital stay was 2.83 days (SD ± 1.75). No serious adverse events (AEs) occurred intraprocedurally. The most common AE during the procedure was abdominal pain (65.22%, Grade 1). Minor nontarget embolization occurred in 2 patients (8.70%); 1 of these cases led to localized portal vein thrombosis (<50% lumen occlusion). The most common postprocedure AEs were new or worsening esophageal varices (47.83%, Grade 2) and ascites (21.74%, Grade 2).

CONCLUSIONS

Cya-BRTO is a feasible, effective, and safe interventional approach for GVs and SRS. By allowing immediate balloon catheter removal, it shortens intensive care and hospital stay, thus offering a potential alternative treatment option.