Hepatic Encephalopathy from Dual Splenorenal Shunts Treated with Balloon-Occluded Retrograde Transvenous Obliteration by Using a Double-Balloon Technique

The authors report on their experience with a 61-year-old woman with hepatic encephalopathy and two large splenorenal shunts. She was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Retrograde injection of the sclerosant into the shunt was performed with balloon occlusion of the two vessels draining into the left renal vein, and complete occlusion was achieved without complications. After B-RTO, the patient's clinical symptoms improved substantially and contrast-enhanced computed tomography (CT) performed 3 months later demonstrated complete thrombosis of the splenorenal shunts.