Abstract: Objective Gastric varices (GV) bleeding is one of the rare types of gastrointestinal bleeding resulting from portal hypertension in patients with liver cirrhosis (LC), but the risk is the highest. The failed endoscopic treatment is common. The purpose of this study was to investigate the safety and short-term efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) in the treatment of patients with LC and GV bleeding. Methods 13 patients with LC and GV were encountered in Nanjing Drum Tower Hospital between November 2018 and January 2020, and all underwent BRTO. The patients were followed-up and the success rate of BRTO procedure, short-term postoperative complications, variceal bleeding and survival were recorded. Results The technical success rate was 92.3%, and there was no serious or fatal complications in our series during two month follow-up period after BRTO; two patients (16.7%) showed new portal vein thrombosis discovered by color Doppler ultrasonography after BRTO, and they disappeared after anticoagulation therapy with low molecular weight heparin; none of the patients suffered from esophageal or gastric variceal bleeding, and one patient died of hepatic failure owing to primary liver cancer; one patient had mild ascites, and one patient with hepatic encephalopathy before BRTO had an obvious decrease of blood ammonia level and remission of clinical symptoms. Conclusion BRTO might be a safe and effective interventional technique, which could prevent gastric variceal bleeding and warrants further investigation.

Key words: Liver cirrhosis, Gastric varices, Balloon-occluded retrograde transvenous obliteration, Bleeding, Therapy