Balloon occluded retrograde transvenous obliteration

Balloon occluded retrograde transvenous obliteration (BRTO)

BRTO is an endovascular technique used as a therapeutic adjunct or alternative to TIPS in the management of gastric varices.

It involves the use of occlusion balloons to occlude the outflow veins of a portosystemic shunt and endovascular injection of a sclerosing agent directly into the varix.

BRTO is the primary method used in Japan and Korea for the management of gastric varices as opposed to the United States and Europe where the primary management of gastric varices has been portal decompression with TIPS.

Its use is growing in the United States


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