Portal hypertension refers to high blood pressure in the liver. One of the major complications of portal hypertension is gastric variceal bleeding. Varices are dilated vessels which may rupture, causing variceal bleeding. BRTO stands for balloon-occluded retrograde transvenous obliteration. BRTO is performed for patients with bleeding related to gastric varices.
When you come in to be treated for gastric varices, your doctor will talk to you about your medical history and perform diagnostic testing, which may include an MRI or CAT scan. Once it is determined that you are a good candidate for the procedure the next step is to schedule treatment.
Candidates are patients that present with or are at risk for the following:
BRTO is a safe procedure that can preserve liver function by blocking blood from the left renal vein to the enlarged veins around the stomach
When you come in for your procedure, you will either have local anesthesia with sedation, or general anesthesia – whatever you and your interventional radiologist (IR) have discussed. The doctor will insert a thin, flexible tube with a tiny balloon on one end through a vein in your thigh or neck. Using image guidance, the catheter will be directed to the veins between the left kidney and the stomach. The balloon will then be inflated to prevent leakage of the sclerosing agent. Sclerosing agents are irritating chemicals that are inserted into the vein that causes the vein to become inflamed leading to scar tissue that blocks the opening. Then, the sclerosing agent and/or coils are placed to block the blood supply to the vein.
Once x-rays confirm that the embolization has been successful the balloon will be deflated and removed.
Typically the procedure will require an overnight stay in the hospital. If you have no signs of bleeding from the stomach, you should be able to go home the next day.
Procedure-related complications are minor and include bleeding and infection. In rare cases, the blockage of the blood to the varices can further increase the pressure on the liver, causing damage.
Whether or not you are a candidate for BRTO will depend on your diagnosis and consultation with your interventional radiologist. But if you suffer from gastric varices this minimally invasive procedure could help prevent or reduce the number of life-threatening bleeds. Call IVC today at 503-612-0498 for more information or to schedule a consultation.
I’ve been a pt of Dr. Pfisters for over 10yrs, during which time he has performed 5+ procedures. As a medical professional myself, I have an exceptionally high expectation of the quality of care I receive, as well…and JUST AS IMPORTANT…the attitude and respect my Dr’s and healthcare team provide! Dr. Pfister and the staff on his team get AA+++ from me!!!!! He is kind, respectful, informative AND an EXCEPTIONALLY skilled interventional radiologist!!! I won’t EVER trust anyone else!!!
P.R.I had a procedure with Dr. Jamie All this past week, and everything about the experience was exceptional. Dr. All is newer to the practice, and brings with him expertise on new practices and procedures (one of which was what I was seeing them for).
From start to finish:
What makes this space, however, is the staff. Patty, my nurse, was amazing. She was calm and efficient, friendly, and took time answering questions and making sure I was as comfortable as possible. She had clearly taken the time to read my charts, which was a new experience for me–generally, when I’ve had procedures, the nurses and doctors have never looked at my charts before and are reading them in front of me. Patty, on the other hand, took time to talk to me about some items in my chart, as well as to go over the procedure with me (it was a new way of performing the procedure for this facility, but she clearly had taken the time to get familiar with the ins-and-outs of what would need to happen, when, and how). She stayed with me through prep, and then through my entire (several hour) recovery, making sure everything went exactly according to plan. She also made me an awesome surgical-glove balloon animal (I am not a kid, but come on, who doesn’t love balloon animals?)! Her thoroughness, patience, and thoughtfulness really made the experience much less stressful than any surgical procedure I’ve previously had.
Then there was Dan, the Anesthesia Nurse (I hope I got that title correct). He was fantastic. It was clear he, too, had read my chart, and he talked with me about everything they would be using and why. I have several sensitivities regarding anesthesia, and have had some pretty horrible experiences, so this was the part I was most nervous about. I’m small, and often this seems to present issues for whatever reason. Not so with Dan. He’d tailored things to my sensitivities, and everything went as promised: I went to sleep easily, and woke up quickly with no nausea. I was fully awake and alert–as though I’d never really had a procedure–very quickly. I even ate a bit before leaving the recovery area. My pain was pretty much non-existent, and was really well-managed over the course of the next couple days thanks to his research on options (I don’t handle narcotics/painkillers well at all).
The surgical theater staff, who you really only meet for a few brief moments once you’re wheeled in but before you are sent to sleep, all took time to say hi, be reassuring, and just generally had an upbeat attitude. Dan asked me what music I’d like to listen to, but honestly, that is the last thing I remember (which is a good thing–no one wants to wake up in the middle of surgery);but, I am going to assume that there is, indeed, music for those patients that are doing something more like twilight sedation. The theater itself was very modern, clean, and stocked with warm blankets for the patients who, like me, prefer toasty feet.
Thank you to Dr. All and the entire staff for making this experience easier and less stressful than I could have imagined it could be.”
S.K.From the time I first spoke to Maryanne who was so kind, and walked thru your doors with friendly smiles to greet me – meeting Patty who was so kind and caring and meeting Dr. Love – great bedside manner and smile and made sure all my questions were answered – and having the port placed with an excellent team – Paul asking me what my hobbies were first thing – I knew I was in the right place! Thank you all, you all are amazing!
AnonymousOne of our best medical experiences during our entire cancer treatment. Thanks so much for everything!
AnonymousThis is for Dr. Pfister. I just wanted to thank him for all the time he spent with us the other week. In all the years I’ve had my vascular problems I’ve never had a doctor really sit down and explain to me the intricacies of what might be going on. I have a lot to think about…but just wanted to say thanks for being so nice and answering our many questions!
L.H.A fantastic group of wonderful people. The procedure was very smooth. When they were putting the port in I felt like I was getting a great massage!! Thank you all!
S.C.Charley was instrumental in getting me scheduled in quickly to get my PICC line removed. She actually worked until late in the day to get the information from my referring doctor’s office. It is nice to know great people like Charley still exist in this world!
K.S.I had my blood clot filter removed on 2/21/18. I was very apprehensive, yet EVERYONE in Dr. Pfister’s office and surgical team helped to make me comfortable. I am extremely claustrophobic so laying down or having something covering my face creates anxiety. Mary Anne listened to my concerns and made sure I was made comfortable and did not feel anxious. The surgical team was amazing, they explained everything thoroughly. Dr. Pfister came in after the procedure to review what he did and discuss any follow up that might be required. I so appreciate the time and attention he gives me as his patient. This was a positive experience.
G.H.110% Thank You! Best unit so far in my cancer treatment. Thanks Dr. Love
AnonymousIf you ever need an Interventional Radiologist for a child I realize it is serious business. I’ve seen Dr. Love go and save a child’s kidney without missing a beat. I could recommend no one better for myself, or for people I love. I think he is a little cool at the bedside, but that’s OK Dr. Love, stay frosty! If you can’t see Dr. Love, one of the other professionals at IVC will be able to help you. Ashley, the dynamite scheduler and one of the other surgeons at IVC will care for you. I’ve had multiple surgeries with this practice over the past several years. Never a hiccup!
S. R. – Portland, ORGreat experience, doctor was thorough in explaining what was going to happen. The nurses were very attentive and made sure I was comfortable and my needs were met. I would recommend this office for any related procedure.
AnonymousEverything went very smoothly. Joe enjoyed the music. Very friendly staff! Good Experience!
J. & E.All staff was courteous and efficient. Good experience.
J. J.Dr. Pfister, thanks so much for your excellent care, removing my chemo port earlier this week. With all your experience and your fine touch, I’m confident the scar will be nearly invisible. Your team, from beginning to end, did a super job with me. Please extend my gratitude to Jennifer, Mary Anne, Todd and Charley. I’ve got a whole lot of living left to do. I appreciate all of you helping me do it!
M. F.Dr. Pfister, thank you for all of the attention you gave to me. I learned lots from our discussion – hearing you speak of ultimate healing was enough to encourage me to do all I can to strengthen those muscles.
S. O.The entire office is one of the most professional, helpful and informative medical offices I have dealt with (and I have dealt with many). Kudos to Jennifer, Henry, and Charley!
K. C.Great people. Great place. Good surgery.
G. G.Patty, Mary Anne and the whole staff was amazing! Best experience I’ve had since being diagnosed with cancer. From start to finish, was great. Thanks.
MMy brother came into Legacy Meridian Park, had a stroke. Dr. Bauer came in immediately, in his work jeans and shirt. He worked with Neurologist Dr. Burbank, developed a plan and took my brother into a procedure where they removed the clot from his head! Very down to earth doctor, explained procedure to family, worked with sense of urgency.
J. P.I want to comment regarding Dr. Bauer of how he was thorough explaining my CT Biopsy and showing me how on the computer he would get the tissue needed. In all the years of several surgeries I have never felt better going in to have a procedure done. His bedside manner was incredible. I wish all doctors were like Dr. Bauer. Thank you for preparing and relaxing me prior to the biopsy.
R.S. Molalla OREveryone did a superb job taking care of me and doing the procedure. Thank You All
K.S.Dr. Bauer genuinely cares about his patients and strives to make sure they understand every aspect of their treatment.
A. L.Dr. Bauer, our family wants you to know how thankful we are to you for saving G.P.’s life and bringing him back to us in normal health. Thank you over and over you are the best!
Family of G. P.