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Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for Treatment of Gastric Varices: Review and Meta-Analysis
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Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for Treatment of Gastric Varices: Review and Meta-Analysis
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Journal Article
Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) for Treatment of Gastric Varices: Review and Meta-Analysis
2015
Overview
Aim
To perform a systematic review and meta-analysis of the effectiveness and complications of BRTO for gastric varices.
Materials and Methods
A systematic review was performed to identify relevant articles. Inclusion criteria were applied to select studies with at least ten patients with acute bleeding or at-risk gastric varices treated with BRTO. Meta-analysis with random effects model was performed to calculate data for immediate technical success, clinical success, and complications.
Results
A total of 1,016 Patients from 24 studies met inclusion criteria. Technical success rate for BRTO was 96.4 % (95 % CI 93.7, 98.3 %;
Q
= 3,269.26,
p
< 0.01,
I
2
= 99.39 %). Clinical success (defined as no recurrence or rebleed of gastric varices, or complete obliteration of varices on subsequent imaging) rate was 97.3 % (95 % CI 95.2, 98.8 %;
Q
= 3,105.91,
p
< 0.01,
I
2
= 99.29 %). Major complication rate was 2.6 % (95 % CI 1.1, 4.6 %;
Q
= 3,348.98,
p
< 0.01,
I
2
= 99.34 %). Esophageal variceal recurrence rate was 33.3 % (95 % CI 24.6, 42.6 %;
Q
= 7,291.75,
p
< 0.01,
I
2
= 99.74 %).
Conclusion
BRTO is safe and efficacious for gastric varices, and current best evidence suggests that BRTO could be considered as therapy for patients with gastric varices.
Publisher
Springer US,Springer,Springer Nature B.V
