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Use of a Coda Balloon to Assist Left Renal Vein Sheath Delivery During Balloon-Occluded Retrograde Transvenous Obliteration 

Use of a Coda Balloon to Assist Left Renal Vein Sheath Delivery During Balloon-Occluded Retrograde Transvenous Obliteration
Chapter:
Use of a Coda Balloon to Assist Left Renal Vein Sheath Delivery During Balloon-Occluded Retrograde Transvenous Obliteration
Author(s):

S. Lowell Kahn

DOI:
10.1093/med/9780199986071.003.0082
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date: 27 February 2020

Fundamental to all balloon-occluded retrograde transvenous obliteration procedures is the catheterization of the gastric varix via its drainage through a gastrorenal shunt and its subsequent sclerosis. Although routinely performed with little difficulty in experienced hands, there exist clinical scenarios and anatomic factors that present technical challenges to the procedure. A common challenge is the delivery of the occlusion balloon to the neck of the gastrorenal shunt to allow occlusion. Two main factors affect this: the angulation of the veins relative to one another and the size of the balloon required to achieve occlusion. This chapter describes a technique to facilitate delivery of a sheath to the left renal vein from a femoral approach when the caudal angulation of the left renal vein makes catheterization unfavorable.

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