Radiology Case Reports (Dec 2023)
Afferent vein embolization via retrograde approach as a potential treatment strategy for bleeding duodenal varices
- Atsushi Jogo, MD, PhD,
- Akira Yamamoto, MD, PhD,
- Ken Kageyama, MD, PhD,
- Fumi Sasaki, MD,
- Tatsushi Oura, MD,
- Yasuhito Mitsuyama, MD,
- Eisaku Terayama, MD,
- Kazuki Matsushita, MD,
- Kazuo Asano, MD,
- Yuki Sakai, MD,
- Masanori Ozaki, MD,
- Shohei Harada, MD,
- Kazuki Murai, MD, PhD,
- Mariko Nakano, MD, PhD,
- Etsuji Sohgawa, MD,
- Ryuichi Kita, MD, PhD,
- Toshio Kaminou, MD, PhD,
- Yukio Miki, MD, PhD
Affiliations
- Atsushi Jogo, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan; Corresponding author.
- Akira Yamamoto, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Ken Kageyama, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Fumi Sasaki, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Tatsushi Oura, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Yasuhito Mitsuyama, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Eisaku Terayama, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Kazuki Matsushita, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Kazuo Asano, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Yuki Sakai, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Masanori Ozaki, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Shohei Harada, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Kazuki Murai, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Mariko Nakano, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Etsuji Sohgawa, MD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Ryuichi Kita, MD, PhD
- Department of Gastroenterology, Osaka, Japan
- Toshio Kaminou, MD, PhD
- Advanced Imaging and Minimally Invasive Therapy Center, Himeji, Japan
- Yukio Miki, MD, PhD
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
- Journal volume & issue
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Vol. 18,
no. 12
pp. 4327 – 4330
Abstract
The standard treatment for ruptured duodenal varices remains to be established. Emergency balloon-occluded retrograde transvenous obliteration is challenging in patients with bleeding because re-rupture of varices can occur due to increased pressure when using the retrograde approach. Herein, we describe a case in which a catheter was retrogradely advanced to the afferent vein beyond bleeding duodenal varices; however, the varices re-ruptured during coil embolization, and a part of the catheter was deviated into the intestinal tract. The rupture site was embolized by liquid embolic materials from the microcatheter. Embolization via retrograde approach needs to be carefully performed.
