Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
4 days ago
Nocturia is a risk factor for mortality, according to the results of the Nagahama Study, which boasts of a low incidence of missing data and high representation of the general population.

BRTO for gastric varices reduces rebleeding, mortality at 1 year

29 Jul 2020

Treatment with balloon-occluded retrograde transvenous obliteration (BRTO) results in lower rates of rebleeding, postprocedure hepatic encephalopathy, and mortality at 1 year in patients with gastric varices (GVs) due to portal hypertension, a study has shown.

“BRTO should be considered first-line modality for the treatment of GVs because of portal hypertension,” the investigators said.

A systematic review and meta-analysis were conducted to compare the feasibility, efficacy, and safety of BRTO and transjugular intrahepatic portosystemic shunt (TIPS) in GV patients. The databases of PubMed, Embase, Google Scholar, and Cochrane Library were searched from inception through March 2019 for eligible studies.

The investigators used a random-effects model to estimate summary odds ratio (OR) with 95 percent confidence intervals (CIs) for technical success, haemostasis rate, postprocedural complications, rebleeding rate, incidence of hepatic encephalopathy, and mortality rate at 1 year.

Only seven studies, including a total of 676 patients (BRTO, n=462; TIPS, n=214) were eligible for the meta-analysis. No significant between-group difference was observed in terms of pooled technical success rate (OR, 0.87, 95 percent CI, 0.28–2.73; p=0.81), haemostasis rate (OR, 2.74, 95 percent CI, 0.61–12.26; p=0.19), and postoperative procedure-related complications (OR, 1.95, 95 percent CI, 0.44–8.72; p=0.38).

However, treatment with BRTO correlated with lower rates of postoperative rebleeding (OR, 0.30, 95 percent CI, 0.18–0.48; p<0.00001), postoperative encephalopathy (OR, 0.06, 95 percent CI, 0.02–0.15; p<0.00001), and mortality at 1 year (OR, 0.43, 95 percent CI, 0.21–0.87; p=0.02).

“Although GV bleeding is less common than oesophageal variceal bleeding, the severity of GV bleeding is often greater with higher morbidity and mortality rates,” the investigators said. “Minimally invasive endovascular treatments such as BRTO and TIPS have been used for the management of GVs with varying results, and individual and institutional differences exist in the use of BRTO and TIPS.”

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Weight suppression appears to result in future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviours, suggesting weight-suppressed women represent an at-risk group that may benefit from selective prevention programmes, a study has found.
4 days ago
Nocturia is a risk factor for mortality, according to the results of the Nagahama Study, which boasts of a low incidence of missing data and high representation of the general population.