Direct percutaneous approach for endoluminal glue embolization of stomal varices.
The present report describes the authors' experience with direct endoluminal embolization for bleeding stomal varices. Between December 1998 and July 2006, seven patients with enterostomies, portal hypertension, and recurrent stomal variceal bleeding resistant to medical treatment were treated at a single institution. Ultrasonography was used to guide direct puncture of the varices. Direct endoluminal embolization with cyanoacrylate glue was performed under fluoroscopic control imaging. Embolization was successful in six of seven cases. One patient with hepatocellular carcinoma and complete portal thrombosis had three recurrences treated with the same technique, with clinical success. Three patients died at 3, 8, and 18 months without recurrence of bleeding. Although further evaluation is indicated, direct percutaneous embolization appears to be a potential alternative treatment for bleeding stomal varices.
Thouveny
Francine
F
Department of Radiology, Centre Hospitalier Universitaire Angers, 49933 Angers Cedex 09, France.
Aubé
Christophe
C
Konaté
Anselme
A
Lebigot
Jérôme
J
Bouvier
Antoine
A
Oberti
Frédéric
F
D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D054047:Surgical Stomas / Q000098:blood supply*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D014014:Tissue Adhesives; D007459:Iodized Oil; D004659:Enbucrilate