{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:59:34Z","timestamp":1785423574196,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Balloon\u2010occluded retrograde transvenous obliteration (BRTO) is widely performed for treating gastric varices (GVs). However, worsening of esophageal varices (EVs) can be observed after BRTO. This study aimed to investigate the impact of EV worsening on prognosis after BRTO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Overall, 258 patients who underwent initial BRTO for GV treatment between January 2004 and May 2019 at 12 institutions were retrospectively registered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Technical success was achieved in 235 patients (91.1%). Based on the exclusion criteria, 37 patients were excluded, and 198 were evaluated. The cumulative worsening rates of EVs at 1, 2, and 3\u00a0years were 39.0%, 59.4%, and 68.4%, respectively. In the univariate Cox proportional hazards model, sex, EV size, history of EV treatment, left gastric vein dilatation, platelet count, aspartate transaminase (AST), alanine aminotransferase (ALT), total bilirubin, albumin, albumin\u2013bilirubin score, prothrombin time\u2010international normalized ratio, fibrosis\u20104 index, AST to platelet ratio index, and spleen width were significantly associated with worsening of EV after BRTO. Multivariate analysis showed that sex (adjusted hazard ratio [aHR] 1.72; 95% confidence interval [CI] 1.03\u20132.86; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04), left gastric vein dilatation (aHR 1.90; 95% CI 1.17\u20133.10; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), ALT (aHR 1.01; 95% CI 1.00\u20131.03; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), albumin (aHR 0.61; 95% CI 0.43\u20130.87; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), and spleen width (aHR 1.02; 95% CI 1.01\u20131.03; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) were independent risk factors for worsening of EV after BRTO. Patients with EV worsening within 1\u00a0year after BRTO had a significantly worse prognosis than the other patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early worsening of EV after BRTO was associated with poor prognosis after BRTO.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15853","type":"journal-article","created":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T23:48:17Z","timestamp":1650239297000},"page":"1148-1155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic impact of worsening of esophageal varices after balloon\u2010occluded retrograde transvenous obliteration"],"prefix":"10.1111","volume":"37","author":[{"given":"Kazuma","family":"Shinkai","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-607X","authenticated-orcid":false,"given":"Ryotaro","family":"Sakamori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9116-7054","authenticated-orcid":false,"given":"Yuki","family":"Tahata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutoshi","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital  Amagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Toyonaka Municipal Hospital  Toyonaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichi","family":"Tawara","sequence":"additional","affiliation":[{"name":"Osaka General Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuto","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Ikeda Municipal Hospital  Ikeda Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Suita Municipal Hospital  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"National Hospital Organization Osaka National Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ito","sequence":"additional","affiliation":[{"name":"Japan Community Health Care Organization Osaka Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Doi","sequence":"additional","affiliation":[{"name":"KKR Otemae Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaharu","family":"Iio","sequence":"additional","affiliation":[{"name":"Hyogo Prefectural Nishinomiya Hospital  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Sakakibara","sequence":"additional","affiliation":[{"name":"Yao Municipal Hospital  Yao Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"National Hospital Organization Osaka Minami Medical Center  Kawachinagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6250-1324","authenticated-orcid":false,"given":"Takahiro","family":"Kodama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-7315","authenticated-orcid":false,"given":"Hayato","family":"Hikita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohide","family":"Tatsumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5036-3457","authenticated-orcid":false,"given":"Tetsuo","family":"Takehara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160607"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i8.1247"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.2008.05651.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100031\u20101284461"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.4.01841340"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/919371"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i12.1373"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31718"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1051\u20100443(07)61912\u20105"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.2008.05549.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.1996.tb00010.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443\u20101661.2009.00929.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904013401302"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250608"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41424\u2010018\u20100021\u20108"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12246"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044456"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168\u20108278(02)00420\u20108"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318126c154"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270\u2010013\u20100809\u20106"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.140"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58020205"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.8.1200"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004836\u2010200201000\u201000016"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.001"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55070335"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v13.i6.650"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1198"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15853","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.15853","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15853","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T21:01:31Z","timestamp":1692824491000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.15853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,26]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/jgh.15853"],"URL":"https:\/\/doi.org\/10.1111\/jgh.15853","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,26]]},"assertion":[{"value":"2021-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}