Accelerated Balloon-Occluded Retrograde Transvenous Obliteration Without Indwelling Balloon Occlusion for Gastric Varices With Small Gastrorenal Shunts Using a Terminal Gelfoam Plug

OBJECTIVE. We performed balloon-occluded retrograde transvenous obliteration in three consecutive patients with small gastric varices without indwelling balloon catheter occlusion. Foam of 3% sodium tetradecyl sulfate mixed with iodized oil and room air was injected retrograde through the gastrorenal shunt, followed by a thick absorbable gelatin sponge (Gelfoam, Pfizer) plug under only 10-minute balloon occlusion. CONCLUSION. Because complete obliteration of gastric varices was achieved in all patients without any complications, our technique is considered to be safe and effective for small gastric varices.