Usefulness of coil-assisted retrograde transvenous obliteration II (CARTO-II) for the treatment of ascending colonic varix: a case report

CVIR Endovascular

article

Maeda, Hiroyuki¹  Murai, Kazuki¹  Ogawa, Satoyuki¹  Miki, Yukio¹  Kageyama, Ken¹  Yamamoto, Akira¹  Jogo, Atsushi¹  Sohgawa, Etsuji¹  Matsushita, Kazuki¹  Asano, Kazuo¹  Yonezawa, Hiroki¹  Nota, Takehito¹ 

[1] Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University

关键词: Ectopic varices;    Ascending colonic varices;    B-RTO;    CARTO-II;   

DOI  :  10.1186/s42155-020-00187-2

学科分类：计算机科学（综合）

来源: Springer

【 摘 要 】

Colonic varices are rare among ectopic varices. A previous report demonstrated that once bleeding from colonic varices occurs, it can be fatal. Several treatments for colonic varices exist, including surgical, endoscopic, and endovascular treatments; however, management of colonic varices has not been standardized. For colonic varices, minimally invasive therapies would be desirable. Balloon-occluded retrograde transvenous obliteration (B-RTO) is one of the treatment options for colonic varices to prevent their rupture. Two cases of successful conventional B-RTO for these varices have already been reported. However, B-RTO using coil-assisted retrograde transvenous obliteration II (CARTO-II) procedure for these varices has not been reported. A 71-year-old male patient had liver cirrhosis caused by hepatitis C virus infection. A varix was located at the ascending colon, which was coincidentally found on colonic endoscopy. Contrast-enhanced computed tomography (CT) showed that the feeder vein was the ileocolic vein and that the main draining vein was the right renal vein. Physicians concluded that treatment was required to avoid the risk of death from massive bleeding due to varix rupture. However, endoscopic and surgical treatments were difficult due to the anatomical location of the varix and the high risk of operative compilations, respectively. This ascending colonic varix was treated by balloon-occluded retrograde transvenous obliteration (B-RTO) using coil-assisted retrograde transvenous obliteration II (CARTO-II) procedure via the right renal vein. There were no complications during the procedure and no recurrences for 36 months during long-term follow-up. CARTO-II can be one of the effective treatment techniques for ascending colonic varices.

【 授权许可】

CC BY