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

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

J Gastroenterol 2007; 42:663-672.

AJR Am J Roentgenol 2005; 184:1340-13460

Meta-analysis 1995-2012

N=1016

Technical Success = 96.4%

Clinical Success = 97.3%

Rebleeding Rate = 2.7%

Survival

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