医学
食管静脉曲张
肝性脑病
气球
静脉曲张
胃肠病学
内科学
脑病
胃静脉曲张
门脉高压
放射科
外科
肝硬化
作者
Shigeo Iwasaki,Haruki Uojima,Shinya Sakita,Sakue Masuda,Kousuke Kubota,Tomoaki Fujikawa,Tomomi Okubo,Toru Setsu,Norio Itokawa,Yoshihiro Furuichi,Yoshitaka Arase,Toshiki Tukiyama,Kaoru Fujii,Hiroyoshi Hidaka,Makoto Chuma,Tatehiro Kagawa,Makoto Kako,Shuji Terai,Chika Kusano
出处
期刊:Digestive Diseases
[S. Karger AG]
日期:2024-09-30
卷期号:: 1-15
摘要
Background: To evaluate esophageal varices (EVs) as predictors of poor prognosis with low tolerability after balloon-occluded retrograde transvenous obliteration (BRTO) in patients with overt hepatic encephalopathy (HE). Methods: This study retrospectively enrolled 107 patients who underwent BRTO for uncontrollable overt HE. The enrolled patients were divided into two groups based on the presence of EVs using propensity matching. The present study assessed the technical success rate and safety of BRTO in both the groups. Further, the event-free survival, HE-free survival, and the overall survival (OS) were compared between the two groups. Event-free survival was defined as the time period during which the patients did not developed complications related to portal hypertension, including EVs, hepatic ascites, and portal vein thrombosis. Results: After propensity matching, the EV and non-EV groups had 37 and 36 patients, respectively. Only one patient experienced an unsuccessful procedure in the EV group. Procedure-related adverse events in the EV group and non-EV group occurred in 11 and 7 patients, respectively. (P=0.417) The event free survival after BRTO in the EV and non-EV group were 1,283 (95% CI: 798 – 1,767) days and 2,257 (1,722–2,792) days, respectively. Event free survival was significantly worse in the EV group than in the non-EV group (P=0.014). Furthermore, the EV group experienced worse OS than the non-EV group (P=0.001 and P<0.001, respectively). Conclusions: The presence of EVs could potentially be associated with a higher risk of adverse outcomes or mortality after BRTO treatment in individuals with HE.
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