A cirrhotic patient with isolated large gastric varices and a spontaneous gastrorenal shunt on CT undergoes balloon-occluded retrograde transvenous obliteration (BRTO). During the procedure, the balloon is inflated in which vessel?

• A Left gastric vein
• B Splenic artery
• C Right hepatic vein
• D Gastrorenal shunt draining into the left renal vein ✓

Explanation

In BRTO, accessed transfemorally through the left renal vein, a balloon catheter is advanced into the gastrorenal (gastroleft adrenal) shunt and inflated to occlude outflow. A sclerosant such as ethanolamine oleate is then injected retrogradely into the gastric varix and left in place until sclerosis is complete. The left gastric vein is the inflow feeder, not the site of balloon occlusion, and the procedure is entirely venous.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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