Transhepatic embolization of varices.
Percutaneous transhepatic embolization of varices (PTEV) has proved to be effective in the control variceal bleeding, particularly in Child's Class C Category patients whose bleeding was not adequately controlled by pitressin perfusions. PTEV, using Gel-Foam soaked in sodium tetradecyl sulfate, controlled acute variceal bleeding in 71--95% of patients and appears to be more effective as an embolizing agent than bucrylate, which controlled 43--57%. Considering the poor condition of the patients particularly during acute bleeding episodes, PTEV is a relatively safe therapeutic procedure that buys time for the surgeons to perform a decompressive shunt electively as definitive surgery. A one-year recurrent bleeding rate of 30% and a two year recurrence of 37.5% was noted. Thus, for long term control of variceal bleeding, a surgical decompressive shunt is recommended in addition to PTEV.
D002404:Catheterization / Q000295:instrumentation; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000188:drug therapy / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000628:therapy; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D012981:Sodium Tetradecyl Sulfate; D014667:Vasopressins / Q000627:therapeutic use
D014667:Vasopressins; D012981:Sodium Tetradecyl Sulfate