• Joo Yeon Jang, Ung Bae Jeon, Jin Hyeok Kim, Tae Un Kim, Hwaseong Ryu, Mong Cho, Young Mi Hong, and Ki Tae Yoon.
• Department of Radiology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Busan, Korea.
• Medicine (Baltimore). 2021 Dec 10; 100 (49): e28107e28107.

RationaleMost gastric varices at the fundus drain into the left renal vein via the gastrorenal shunt (80-85% of cases) or the inferior vena cava via the gastrocaval shunt (10-15%). Therefore, plug-assisted retrograde transvenous obliteration (PARTO) is usually performed via a gastrorenal shunt. Here, we report a case of gastric varix treated with PARTO via a gastrocaval shunt.Patient ConcernsA 46-year-old woman with hepatitis B virus and liver cirrhosis visited the emergency room in our hospital with the main symptom of hematemesis and hematochezia.DiagnosesEndoscopy and computed tomography (CT) revealed a gastric varix and thrombotic-occluded transjugular intrahepatic portosystemic shunt (TIPS) stent.InterventionsThe patient underwent PARTO via a gastrocaval shunt to manage gastric variceal bleeding after failed TIPS revision.OutcomesOn CT, the gastric varix completely disappeared. The patient did not experience any additional bleeding events.LessonsPARTO via a gastrocaval shunt is safe and effective.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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