Letter to the Editor: Endoscopic Ultrasound–Guided Coil Therapy for Secondary Prevention After Gastric Variceal Bleeding: A Promising Alternative

Bazarbashi, Ahmad Najdat; Li, Michael; Ryou, Marvin

doi:10.1002/hep.31997

Cited by 1 publication

(1 citation statement)

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“…Recently, endoscopic ultrasound-guided coil (EUS-coil) therapy has emerged as a promising option due to its therapeutic superiority over endoscopic glue injection. It is believed that EUS-coil therapy is the next intervention for primary and secondary hemostases of gastric variceal bleeding and will result in a paradigm shift ( 32 , 33 ).…”

Section: Endoscopic Managementmentioning

confidence: 99%

Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein

2022

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Cavernous transformation of the portal vein (CTPV) is a sequela of extrahepatic and/or intrahepatic portal vein obstruction caused by a combination of local and risk factors. It was ever taken as a relatively rare disease due to its scant literature, which was mainly based on clinical series and case reports. CTPV often manifests as gastroesophageal variceal bleeding, splenomegaly, and portal biliopathy after the long-term insidious presentation. It is unable for CTPV to be recanalized with anticoagulation because it is a complete obstruction of the mesentericoportal axis. Endoscopic therapy is mainly used for temporary hemostasis in acute variceal bleeding. Meso-Rex shunting characterized by portal-flow-preserving shunts has been widely performed in children with CTPV. The multitude of complications associated with CTPV in adults can be effectively addressed by various interventional vascular therapies. With the ubiquity of radiological examinations, optimal treatment for patients with CTPV becomes important. Multivisceral transplantation, such as liver-small intestinal transplantation, may be lifesaving and should be considered for patients with diffuse mesenteric venous thrombosis.

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Section: Endoscopic Managementmentioning

confidence: 99%