{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T16:28:51Z","timestamp":1793809731571,"version":"4.6.1"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Duodenal varices, though rare, are potentially life\u2010threatening complications of portal hypertension. Management is challenging when balloon\u2010occluded retrograde transvenous obliteration (BRTO) fails to achieve complete obliteration. Endoscopic ultrasonography\u2010guided variceal therapy (EUS\u2010VT) is effective for gastric varices, but reports of duodenal varices remain limited. We present a case of a 71\u2010year\u2010old woman with alcoholic liver cirrhosis and duodenal variceal bleeding. Initial hemostasis was achieved with endoscopic variceal ligation, followed by BRTO. However, rebleeding occurred due to incomplete obliteration caused by dual afferent veins. EUS\u2010VT comprising n\u2010butyl cyanoacrylate was performed as salvage therapy because of ascites and vascular complexity. Despite technical challenges, EUS\u2010VT successfully obliterated the varices. Post\u2010procedural computed tomography showed lipiodol migration into the portal system. No rebleeding or liver dysfunction occurred. Ascites worsened\u2014likely because of BRTO and\/or EUS\u2010VT\u2014but was manageable with low\u2010dose diuretics. This case highlights EUS\u2010VT as a feasible option after failed BRTO for duodenal varices. A meticulous technique is essential to preventing glue migration.<\/jats:p>","DOI":"10.1002\/deo2.70183","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T14:16:07Z","timestamp":1755180967000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Endoscopic Ultrasonography\u2010guided Variceal Therapy as Salvage Treatment for Rebleeding From Duodenal Varices Following Balloon\u2010occluded Retrograde Transvenous Obliteration"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8127-0154","authenticated-orcid":false,"given":"Sakue","family":"Masuda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Irisawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dokkyo Medical University School of Medicine  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Nakaya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8903-6207","authenticated-orcid":false,"given":"Jun","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3059-495X","authenticated-orcid":false,"given":"Karen","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makomo","family":"Makazu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital  Kanagawa 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