Patient Education Material

Portal hypertension refers to high blood pressure in the liver. One of the major possible complications of portal hypertension is gastric variceal bleeding. Varices are dilated vessels that may rupture, causing variceal bleeding. Gastric variceal bleeding describes the bleeding that occurs when dilated vessels in the stomach rupture and, is associated with high morbidity and mortality rates.

BRTO is a minimally invasive technique that is used to treat gastric variceal bleeding. The procedure involves blocking the dilated vessels, reducing the risk of rupture. It can be used in addition to or as an alternative to TIPS, which is the primary treatment for gastric varices. TIPS aims to relieve the pressure on the dilated vessels by creating new connections between blood vessels in the liver using a shunt.


You may be advised to undergo this procedure if you are at risk of or already have gastric variceal bleeding and hepatic encephalopathy as well as a gastrorenal shunt. Hepatic encephalopathy refers to the worsening of brain function that is caused by a damaged liver.

BTRO is a less invasive and more effective way to manage varices than shunt surgery or TIPS. TIPS may not always cause the disappearance of gastric varices, while BRTO can in most cases completely destroy these vessels.

BRTO has tended to be used to prevent gastric variceal bleeding. It is also an effective therapy for sclerosis (narrowing) of new portosystemic shunts with the additional complication of hepatic encephalopathy. One of the greatest advantages of BRTO is its preservation of liver function. Moreover, the increase of blood flow in BRTO can also improve liver function in cases where the patient has scarring of the liver.

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