학술논문
Hepatic venous pressure gradient after balloon-occluded retrograde transvenous obliteration and liver stiffness measurement predict the prognosis of patients with gastric varices
Document Type
article
Author
Yuki Shirane; Eisuke Murakami; Michio Imamura; Masanari Kosaka; Yusuke Johira; Ryoichi Miura; Serami Murakami; Shigeki Yano; Kei Amioka; Kensuke Naruto; Yuwa Ando; Shinsuke Uchikawa; Yuji Teraoka; Takuro Uchida; Hatsue Fujino; Atsushi Ono; Takashi Nakahara; Tomokazu Kawaoka; Daiki Miki; Masami Yamauchi; Wataru Okamoto; Masataka Tsuge; Keigo Chosa; Kazuo Awai; Hiroshi Aikata; Shiro Oka
Source
BMC Gastroenterology, Vol 22, Iss 1, Pp 1-9 (2022)
Subject
Language
English
ISSN
1471-230X
Abstract
Abstract Background Balloon-occluded retrograde transvenous obliteration (BRTO) is a treatment option for patients with gastric varices (GVs). This study aimed to clarify the clinical significance of portal hypertension estimated by the hepatic venous pressure gradient (HVPG), subsequent exacerbation of esophageal varices (EVs), and prognosis of patients who underwent BRTO for GVs. Methods Thirty-six patients with GVs treated with BRTO were enrolled in this study, and their HVPG was measured before (pre-HVPG) and on the day after BRTO (post-HVPG). After BRTO, patients were followed-up for a median interval of 24.5 (3–140) months. Clinical factors related to EVs exacerbation and prognosis after BRTO were retrospectively analyzed. Results Post-HVPG increased compared to pre-HVPG in 21 out of 36 patients (58%), and post-HVPG was overall significantly higher compared to pre-HVPG (P = 0.009). During the observation period, 19 patients (53%) developed EVs exacerbation, and the cumulative EVs exacerbation rates at 1, 3 and 5 years after BRTO were 27%, 67%, and 73%, respectively. Pre-HVPG was not related to EVs exacerbation, although elevation of post-HVPG to ≥ 13 mmHg (P