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Fig. 1A. —Balloon-occluded retrograde transvenous sclerosis. Drawing shows that in standard balloon-occluded retrograde transvenous sclerosis, balloon catheter is inserted into and inflated at left adrenal vein just above left renal vein (long arrow). After varicography to evaluate anatomic details of gastric varices and position of balloon catheter, sclerosant is injected into entire portion of gastric varices and gastrorenal shunt (shaded area). Embolization of collateral vessels (short arrow) from gastrorenal shunts to systemic circulation is occasionally needed for prevention of flow of sclerosant into systemic circulation in patients for whom varicography has shown prominent collateral vessels. IVC = inferior vena cava.