BRTO/PARTO FOR BLOOD IN VOMITING (VARICEAL BLEED)
BRTO/PARTO FOR BLOOD IN VOMITING (VARICEAL BLEED)
What is BRTO/PARTO for variceal bleed:
- It is lifesaving procedure for upper GI bleed (blood in vomiting) in patient having gastric varices (dilated vascular channels within wall of stomach).
- Gastric varices commonly found in patients with liver cirrhosis (liver damage) and portal hypertension.
Why it is necessary:
- Bleeding from gastric varices can range from asymptomatic to life threatening depending upon size of blood vessel within wall of stomach.
- Sometimes it may present with long time black stool and reduced haemoglobin (anaemia) and sometime present in emergency centre with heavy bleeding from mouth and patient is collapsed.
- So by this procedure we can stop bleeding immediately and save patient life.
How it performed:
- Through very small pinhole within blood vessel at thigh region, we reach at culprit vessel after navigation under fluro guidance.
- After reaching, we completely block those leaky channels with multiple embolizing techniques depending upon culprit vessel diameter and location.
- Balloon assisted or plug assisted, we block those channels so it called BRTO (Balloon Assisted Retrograde Transvenous Occlusion) OR PARTO (Plug Assisted Retrograde Transvenous Occlusion).
What are the benefits:
- By this procedure, patient gets relief from bleeding without any stitches or scar mark.
- Patient is able to walk after few hours of procedure.
Preparation for procedure:
- Few basic blood investigations like CBC, PT/INR, viral markers.
- Bring all the records including imaging record.
- Signing consent form.
What are risks:
- Very few and rare, includes non-target embolization or ulcer (<1 case in 1000).