Fig. 2
From: Balloon-occluded retrograde transvenous obliteration of colonic varices: a case report
BRTO. a Reverse curve catheter (large black arrow) cannulating the right renal vein from right internal jugular venous access contrast opacifying the renal venous shunt (white arrow) and subsequent multiple tortuous porto-systemic collaterals (small black arrows). b Reverse curve catheter has been exchanged for a balloon occlusion catheter which has been inflated (white arrow) in the shunt. Two endoscopic clips denote the location of the culprit varix (black arrow). c Microcatheter (large black arrow), inserted through the central lumen of the inflated balloon occlusion catheter (white arrow), cannulating the extensive colonic varices and opacifying the culprit varix (small black arrow) close to the endoscopic clips (black dashed arrow). d Fluoroscopic image depicting the inflated balloon occlusion catheter (white arrow), microcatheter (large black arrow) inserted deeper into the colonic varix beyond the level of the endoscopic clips (black dashed arrow). e Digital subtraction venography via the microcatheter confirming intraluminal colonic varix opacification (black arrow) prior to injection of sclerosant. f Following sclerotherapy and glue embolization (black arrow), the microcatheter has been removed. Fluoroscopic venogram via the balloon occlusion catheter (white arrow) post treatment with small retroperitoneal collateral filling (black dashed arrow) but no further filling of the culprit varix