Transhepatic Embolization of Varices

Recurrent bleeding of parastomal varices: Case report

“…Transjugular intrahepatic portosystemic shunt (TIPS) and embolization for the management of variceal bleeding are the other treatment alternatives (7). Mesenteric venous embolization has been reported for the treatment of stomal varices, but the portal vein thrombosis may be fatal if this complication occurs in patients (14). All of those methods are more invasive and more complex compared with other local treatment methods.…”

Treatment of Stomal Variceal Hemorrhage with TIPS: Case Report and Review of the Literature

“…Undiagnosed mesentericoportal thrombosis with bowel infarction carries a 15%-50% associated mortality [7]. For example, Widrich et al [8] described a series of 60 patients who underwent percutaneous gastroesophageal variceal embolization. Portal vein thrombosis occurred in five (8%) patients, with associated mortality in two (3%).…”

Complications of Therapeutic Transcatheter Embolization

“…Left-gastric venography should be performed prior to embolization, since 3% of the patients of Widrich et al had direct communication of the gastric vein with the inferior vena cava and another 5% had communications with the left portal vein. 6 Powdered agents are not appropriate for occluding varices, and even Gelfoam plugs as large as 12 × 3 × 2 mm may pass into the lungs. Conroy et al have developed a technique for labeling Gelfoam with 99m Tc pertechnetate that permits immediate recognition of unintended pulmonary or systemic embolization by using a portable gamma camera.…”

“…Sotradecol and hypertonic glucose have been injected safely into esophageal varices and have been helpful in occluding significant collaterals. 6,9 In Europe, a fatty acid of cod liver oil (Varicocid) has been applied to varicoceles with notable success, 32,45 although there is a 1-3% incidence of scrotal phlebitis after treatment. Hypertonic radiographic contrast medium has also been used in varicoceles, 31 as well as to ablate parathyroid glands.…”

“…In the past decade, transcatheter techniques for producing vascular occlusion have met increasing acceptance for treating a variety of acute and chronic medical disorders. A number of embolization techniques have been devised not only for management of acute hemorrhage, [1][2][3][4][5][6][7][8][9][10][11][12][13][14] palliation of tumor, [15][16][17][18][19][20][21] and treatment for arteriovenous malformations 22 " 25 but also for entities such as malignant hypertension and hyperparathyroidism. [26][27][28][29][30][31][32][33][34] Although vessels may be occluded by means of electrocoagulation 35 or thermal injury, 36,37 by far the greatest experience has been obtained with embolic materials, be they particulate, mechanical, polymerizing, or sclerosing (Table I).…”