NBCA embolization of ≥ 3 vasa recta can induce ischemic bowel damage requiring treatment. NBCA TAE of one vas rectum with ≥ 2 branches could also induce ischemic complications. However, these were silent and self-limited.

We report two patients with colon cancer suffering from stomal variceal bleeding who were treated by two different interventional approaches. In case 1, a retrograde approach was applied to perform sclerotherapy of stomal varices, due to liver metastases. After access to the superficial epigastric vein as one of the efferent veins by the percutaneous approach, stomal varices were embolized using a sclerosant under compression of the efferent veins by hand, rolled gauze packs, and balloon occlusion. In case 2, two vascular plugs were placed in the two afferent veins by the antegrade transhepatic approach. Case 1 suffered from massive ascites after the procedure. No recurrent stomal variceal bleeding occurred until the patients' death in both cases. Blood flow reduction to the stoma may be sufficient for patients with a short prognosis.

Sludge can induce transient pulmonary hypertension or cardiopulmonary collapse, without ethanol and may be the mechanism by which ethanol induces its adverse hemodynamic effects.

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