Coil or plug-assisted retrograde transvenous obliteration (CARTO/PARTO) for treating portal hypertensive variceal bleeding: A multicenter, real-world 10-year retrospective study

作者：Edward Lee, Sammy Saab, Navid Eghbalieh, Peng‐Xu Ding, Ung Bae Jeon, Joon Young Ohm, Ronnie C. Chen, Man Deuk Kim, Kichang Han, Dong Jae Shim, Jong Soo Shin, Anirudh Mirakhur, Chien-An Liu, Jonathan Park, Frank Hao, Man Sang Wong, Antonio Moreno, Jasleen Singh, Fady M. Kaldas, Douglas G. Farmer, Juan G. Abraldeṣ · 发表于：Hepatology · 年份：2025 · DOI：10.1097/hep.0000000000001255 · 被引用次数：7 · 研究领域：Liver Disease and Transplantation、Organ Transplantation Techniques and Outcomes、Gastrointestinal Bleeding Diagnosis and Treatment

BACKGROUND AND AIMS: Coil-assisted retrograde transvenous obliteration (CARTO) and plug-assisted retrograde transvenous obliteration (PARTO) are well-accepted treatments for gastric variceal bleeding. However, long-term (>2 y) clinical outcomes have yet to be studied. In this study, we investigated long-term clinical outcomes, including overall survival (OS) in 10 years. APPROACH AND RESULTS: We performed a multinational, multicenter, retrospective study of CARTO/PARTO in gastric varices treatments between May 2012 and July 2024. The primary study outcomes were a long-term OS and prognostic factors of CARTO/PARTO. The secondary outcomes were long-term clinical/technical success, complications, and clinical changes including portal hypertensive symptoms. A total of 311 patients (41% female; 69% CARTO) from 13 centers in 5 countries were included. The cumulative 1-, 3-, 5-, 7-, and 10-year OS rates were 98%, 80%, 68%, 52%, and 33%, respectively, with a median OS of 99 months. Prophylactic CARTO/PARTO showed a better OS than CARTO/PARTO for active bleeding ( p =0.00035). The independent prognostic factors of OS were having high pre-MELD, concurrent HCC, treating GOV2, history of esophageal variceal bleeding, high pre-TBili, and ammonia levels. Notably, a high pre-MELD score >27 had a significantly higher mortality rate (92.6%) than a lower pre-MELD score ( p <0.001). The overall cumulative 1-, 3-, 5-, 7-, and 10-year recurrent gastric varices bleeding rates were 0.9%, 3.2%, 4.0%...