Innovative Use of a Coaxial Double-Balloon Catheter System for Treating Gastric Varices

Herein, we present the case of a 52-year-old female with a history of hepatic surgery who developed gastric varices. Owing to the risk of rupture, a balloon-occluded retrograde transvenous obliteration (BRTO) procedure was performed using a coaxial double-balloon catheter system. Subsequently, the outer balloon catheter was advanced into the gastrorenal shunt. However, venography failed to visualize the varices. Attempts to advance the inner catheter into the varices have been unsuccessful. The inner catheter was advanced into the left gastric vein, establishing a closed circuit around the gastric varices using an outer balloon catheter. A sclerosing agent was subsequently injected through the gap between the outer and inner balloon catheters and via the outer balloon catheter, successfully embolizing the gastric varices. The coaxial double-balloon catheter system is a viable and effective method for treating gastric varices, particularly in cases where traditional BRTO techniques may be challenging owing to their complex vascular anatomy.