Percutaneous transhepatic obliteration of gastro-oesophageal varices.
Percutaneous transhepatic portal-vein catheterisation was attempted to obliterate the major variceal venous supply in 13 decompensated cirrhotic patients, who continued to bleed after conservative therapy. Obliteration was achieved and bleeding stopped in 7 patients. In 5 patients obliteration was technically unsuccessful. The remaining patient had an unsuspected portal-vein block diagnosed by the transhepatic technique. 1 patient with successfully obliterated varices died after a haemothorax and haemorperitoneum developed. Follow-up splenic venography at three to six months in the 6 successfully thrombosed patients showed that 4 had persistent obliteration and had not re-bled. 2 patients re-bled from incompletely obliterated varices. It is concluded that selective obliteration of the major variceal supply is effective in stopping acute gastro-oesophageal variceal bleeding, but that greater experience is necessary before the long-term effectiveness of the procedure can be determined.
D000328:Adult; D000368:Aged; D001201:Ascites / Q000150:complications; D002404:Catheterization; D004621:Embolization, Therapeutic / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008875:Middle Aged; D011169:Portal Vein; D013272:Stomach Diseases / Q000628:therapy; D013917:Thrombin / Q000008:administration & dosage / Q000627:therapeutic use; D014648:Varicose Veins / Q000628:therapy
D013917:Thrombin; D005947:Glucose