A case of liver cirrhosis with solitary gastric varices associated with TIPSS tract and portal vein occlusion after performance of TIPSS and successfully treated with D-BRTO

In addition to TIPSS, balloon occluded retrograde transvenous oblitalation (BRTO) is performed for treatment of solitary gastric varices (Lg-f) due to liver cirrhosis (LC). We treated a case of LC associated with TIPSS tract (TT) and portal vein (PV) occlusion after TIPSS performed for Lg-f by double balloon-BRTO (D-BRTO). A 68-year-old female with LC complicated by Lg-f was treated by TIPSS and six months later, occlusion of main PV (MPV) and TT developed. The occlusion was supposed to be caused by the reduction of blood flow within them due to gastrorenal shunt (GR-S). PTA of TT and D-BRTO through both TT and GR-S were performed for PV ad TT recanalization and improvement of Lg-f. After D-BRTO, Lg-f improved, and PV ad TT were recanalized without any complication. D-BRTO is effective for the treatment of PV ad TT occlusion after TIPSS for Lg-f.