• Jongjoon Shim, Jae Myeong Lee, and Youngjong Cho.
• Department of Radiology, University of Soonchunhyang College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do, Korea.
• Medicine (Baltimore). 2022 Dec 9; 101 (49): e32013e32013.

RatinalePlug-assisted retrograde tansvenous obliteration (PARTO) is commonly used to treat gastric variceal bleeding. PARTO is typically performed via the gastrorenal shunt or gastrocaval shunt and there have been no reports of PARTO performed through the pericardial vein in cases of gastric varices in which there is no gastrorenal or gastrocaval shunt. Herein, we report a case of PARTO was performed to treat gastric variceal bleeding in a patient with a gastric varix without a gastrorenal or gastrocaval shunt.Patient ConcernsA 54-year-old man with alcoholic liver cirrhosis presented to the emergency room with hematemesis and melena. At presentation, the patient's blood pressure was 130/70 mm Hg and hemoglobin level was 10.1 g/dL.DiagnosesComputed tomography (CT) scan and endoscopic examination revealed a gastric varix at the gastric fundus.InterventionsPARTO was performed to treatment of gastric variceal bleeding via the pericardial vein.OutcomesThe patient did not show any signs of variceal bleeding after the procedure, and follow-up CT at 3 weeks showed complete resolution of the gastric varix.LessonsAlthough PARTO is technically difficult to perform through pathways other than the gastrorenal or gastrocaval shunt, it can be a beneficial alternative in cases in which other treatments fail or are not feasible.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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