Balloon-occluded retrograde transvenous obliteration (BRTO) is a medical procedure used to treat gastric varices, which are dilated veins in the stomach that can potentially lead to life-threatening bleeding. This procedure is typically performed by an interventional radiologist.

BRTO is generally considered an effective treatment for gastric varices, particularly when they are large or at high risk of bleeding. However, like any medical procedure, it carries some risks, including potential complications such as thrombosis (blood clot formation), infection, or injury to surrounding tissues. It’s important for patients to discuss the risks and benefits of BRTO with their healthcare provider before undergoing the procedure.

Here’s how the procedure generally works:

1. Identification of Gastric Varices – The doctor first identifies the gastric varices using imaging techniques such as ultrasound, CT scan, or MRI.
2. Venous Access – The doctor gains access to a vein, usually the femoral vein in the groin area, using a needle and catheter.
3. Catheter Insertion – A catheter is then guided through the venous system until it reaches the gastric varices.
4. Balloon Occlusion – Once the catheter is positioned correctly, a balloon is inflated to temporarily block the blood flow in the vein supplying the varices. This helps to isolate the varices and prevent excessive bleeding during the procedure.
5. Sclerosant Injection – A sclerosant, such as STS, is then injected into the varices through the catheter. This causes the varices to shrink and eventually close off.
6. Balloon Deflation and Catheter Removal – After the sclerosant injection, the balloon is deflated and the catheter is removed.

The patient is usually monitored for a period of time after the procedure to watch for any complications and ensure the varices have been successfully treated.

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