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Журнал «Медицина неотложных состояний» Том 19, №1, 2023

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Трансвенозна облітерація варикозно розширених вен шлунка

Авторы: Чуклін С.М. (1), Чуклін С.С. (2)
(1) — Львівський національний медичний університет імені Данила Галицького, м. Львів, Україна
(2) — Медичний центр Святої Параскеви, м. Львів, Україна

Рубрики: Медицина неотложных состояний

Разделы: Справочник специалиста

Версия для печати


Резюме

Варикозне розширення вен шлунка на тлі портальної гіпертензії виникає рідше, ніж варикозне розширення вен стравоходу, але розвивається при нижчому портальному тиску та пов’язане з масивнішими кровотечами та вищим рівнем смертності. Балонно-оклюзійна ретроградна трансвенозна облітерація (BRTO) варикозного розширення вен шлунка є ефективною терапією варикозного розширення вен шлунка, зумовленого портальною гіпертензією. Однак BRTO вимагає тривалого постпроцедурного моніторингу вищого рівня та може мати ускладнення, пов’язані з розривом балона та побічним ефектом склерозуючих речовин. Було розроблено кілька модифікованих методів BRTO, включно з ретроградною трансвенозною облітерацією за допомогою судинного корка, ретроградною трансвенозною облітерацією за допомогою спіралі та антеградною трансвенозною облітерацією за допомогою балона. У цій статті наведено огляд BRTO та її різних модифікованих методів.

Gastric varices on the background of portal hypertension occur less frequently than esophageal varices but they develop at lower portal pressure and are associated with more massive bleedings and higher mortality rate. Balloon-occluded retrograde transvenous obliteration (BRTO) has been well documented as an effective therapy for gastric varices caused by portal hypertension. However, BRTO requires long-term, higher-level post-procedural monitoring and can have complications related to balloon rupture and adverse effects of sclerosing agents. Several modified BRTO techniques have been developed, including vascular plug-assisted retrograde transvenous obliteration, coil-assisted retrograde transvenous obli­teration, and balloon-occluded antegrade transvenous obliteration. This article provides an overview of BRTO various and modified BRTO techniques.


Ключевые слова

шлункові варикси; класифікація; балонно-оклюзійна ретроградна трансвенозна облітерація; балонно-оклюзійна антеградна трансвенозна облітерація; ретроградна трансвенозна облітерація за допомогою судинного корка і спіралі

gastric varices; classification; balloon-occluded retrograde transvenous obliteration; balloon-occluded antegrade transvenous obliteration; plug- and coil-assisted retrograde transvenous obliteration


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