Balloon-occluded retrograde transvenous obliteration for gastric varices via the intercostal vein

Figure 4 The strategy and actual images of balloon-occluded retrograde transvenous obliteration via the intercostal vein. A: Schema of the micro-balloon catheter inserted via the 7th intercostal vein (ICV) and advanced to the gastric varices (GV) through the subphrenic branch vein (SPBV) and subphrenic vein (SPV); B: After balloon inflation (asterisk), balloon-occluded retrograde transvenous obliteration (BRTO) using 5% ethanolamine oleate-iopamidol (EOI) and ethanol mixed with lipiodol was conducted. The radiograph immediately after BRTO showed the accumulation of EOI corresponding to the gastric varices (arrow). PCV: Pericardial vein; CPV: Cardio-phrenic vein.