Balloon-occluded retrograde transvenous obliteration (BRTO) is a minimally invasive procedure used to treat bleeding or high-risk for bleeding gastric varices. Gastric varices are dilated veins in the stomach wall that can develop in patients with liver disease, and can cause life-threatening bleeding if left untreated.
During the BRTO procedure, a catheter is inserted through a vein in the groin and advanced into the vein draining left kidney (renal vein). From the renal vein, the catheter is guided into the veins that drain the gastric varices. A balloon is inflated to block the blood flow through these veins, and a sclerosing agent (a substance that blocks the veins) is injected into the varices through the catheter. The sclerosing agent causes the varices to shrink and eventually disappear, obliterating the risk of bleeding.
BRTO has several advantages over other treatments for gastric varices, including a lower risk of rebleeding and a shorter hospital stay. However, the procedure also carries some risks, including infection, bleeding from other group of varices(oesophageal varices), and damage to nearby organs. Your healthcare provider will discuss the risks and benefits of the procedure with you before it is performed.
BRTO is typically reserved for patients with bleeding gastric varices that have not responded to other treatments, or for patients with a high risk of bleeding due to large or complex varices. Your healthcare provider will determine if you are a candidate for the procedure based on your individual medical history and symptoms.