名词和定义BRTO技术 CARTO PARTO
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孤立性胃静脉曲张:BRTO技术

时间:2020-11-18 13:33来源:未知 作者:Mr.Editor
BRTO B alloon- O ccluded R etrograde T ransvenous O bliteration (BRTO) AJR Am J Roentgenol 2005; 184:1340-1346 BRTO历史 最初病例较少 1. 结果不确定 Unclear outcome no data or poor outcomes 2. 不熟悉硬化剂的使用 Unfamiliarity with sclerosi

BRTO


Balloon-Occluded Retrograde Transvenous Obliteration(BRTO)

   
AJR Am J Roentgenol 2005; 184:1340-1346

最初病例较少


1. 结果不确定 Unclear outcome – no data or poor outcomes
2. 不熟悉硬化剂的使用 Unfamiliarity with sclerosing agents
3. TIPS强势发展  Robust development of TIPS

目前对BRTO的兴趣主要来源于


1. 肝功能差TIPS结果差 Poor outcomes of TIPS on high MELD
2. TIPS术后肝性脑病  Encephalopathy after TIPS
3. BRTO术后肝功能暂时(?)改善 Transient (?) improvement of liver functions after BRTO

治疗结果


  • 有效 Efficacy                           87-100%
  • 再出血率  Rebleeding rate      <10%   
  • 微创 Less invasive                  病人肝功能差,甚至肝性脑病
J Gastroenterol  2007; 42:663-672.
AJR Am J Roentgenol 2005; 184:1340-13460

 
 

消化道出血的结果




Meta-analysis 1995-2012

N=1016

Technical Success = 96.4%
Clinical Success    = 97.3%
Rebleeding Rate =    2.7%

Survival
1 Yr 92.6%  83.1-100%
3 Yr 84.5% 75-100%
5 Yr 65.4% 39-85%
8 Yr 56.7% 45.8-79%
Park JK, Lee EW et al. Dig Dis Sci 2014
 
 

N = 68
 
Technical Success = 93%
 
Rebleeding rate = 3% (2/63)
 
 
预防消化道出血  
Akahoshi T. et al J Gastroenterol Hepatol. 2008;23:1702-1709.



Group A (Endoscopic Injection of cyanoacrylate)
N = 44
31.8% in 1 yr; 41.7% in 5 yrs
 
Group B (BRTO)
 
N = 42
1.9% in 1 yr;
1.9% in 5 yrs
 
Akahoshi T. et al J Gastroenterol Hepatol. 2006
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