Interventional Radiology- Discharge Instructions 

Balloon Occluded Retrograde Transvenous Obliteration   (BRTO)

Balloon Occluded  Retrograde Transvenous Obliteration or BRTO is an effective procedure in the management of gastric variceal bleeding.   With fluoroscopic guidance, blood from the left renal vein to the gastric varices around the stomach is sclerosed and coiled.   It is not abnormal to have soreness in chest and upper stomach and groin site for a few days after your procedure.   However, this pain will gradually improve in time.

POST-PROCEDURE ACTIVITY:

  • A responsible adult must drive you home after the procedure.

  • If you receive sedation for the procedure, you should not drive, operate heavy machinery or do anything that requires concentration for at least 24 hours.

  • It is recommended that a responsible adult be with you until morning.

  • Avoid any exertion for 72 hours.  Do not lift over 10 lbs. and avoid pushing, pulling or straining.

  • Avoid excessive bending, stooping or stair climbing for 2 days.  It is okay to go upstairs or bend over but take it slowly and keep it to a minimum.

POST-PROCEDURE SITE CARE:

  • You will have a small bandage over the site.  Keep this dry.  You may remove it in 24 hours. 

  • You may shower in 24 hours, after removing the bandage.   Wash and dry the site gently. 

  • Do not submerge the site underwater for one week (no tub bath, swimming, hot tub, etc.) 

  • Be sure your hands are clean when touching near the site. 

  • Do not use ointments, creams or powders on the puncture site.

DIET/MEDICATIONS:

  • You may resume your previous diet after the procedure.

  • If you receive sedation or narcotic pain medications, avoid any foods or beverages containing alcohol for at least 24 hours.

  • Please see the Medication Reconciliation sheet for instructions regarding resuming your home medications.

WHEN TO CALL THE DOCTOR:

  • If you have significant bleeding (more than a teaspoon) or swelling at the site (bigger than a golf ball), lie down, apply firm pressure to the site and call 911.  Bleeding from a large vessel requires professional help.

  • If you have signs of infection such as: 

  • Chills, body aches, fever greater than 101⁰F  

  • Redness, swelling or warmth at the puncture site

  • If you have soreness that continues for more than a week or unusual pain at the puncture site.  It is common to have mild soreness or slight swelling at the site for up to 2 weeks. 

  • If you have numbness, tingling, weakness in the leg below the puncture site or your leg becomes cold and pale.

  • If you have persistent nausea or vomiting. 

 For any of the above symptoms or for problems or concerns related to the procedure,  call 913-588-4846 for Monday-Friday 7-5.  After-hours and weekends, please call  913-588-5000 and ask for the Interventional Radiology Resident on-call.