Balloon-occluded retrograde transvenous obliteration (B-RTO) performed on a 47-year-old woman with hepatitis C virus-related liver cirrhosis. A. A balloon catheter was inserted into the gastrorenal shunt. The gastric varices could not be clearly visualized on the venogram because the contrast medium had leaked into the retroperitoneal collateral veins (arrow). B. The retroperitoneal collateral veins were catheterized using a microcatheter and embolized using metallic coils. The gastric varices (arrow) could be clearly visualized on a venogram obtained after embolization of the retroperitoneal veins. C. A contrast-enhanced CT scan obtained before the B-RTO procedure showed gastric varices and gastrorenal shunts. D. A contrast-enhanced CT scan obtained 5 days after the first B-RTO procedure showed complete thrombosis of the gastric varices (arrowhead).