title: Alternative treatment for bleeding peristomal varices: percutaneous parastomal embolization.
abstract: OBJECTIVE
  To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach.
  
  
  METHODS
  The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated.
  
  
  RESULTS
  Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days).
  
  
  CONCLUSIONS
  This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.
authors.affiliation: Department of Radiology, Duke University Hospital, P.O. Box 3808, Durham, NC, 27710, USA, waly.pr@duke.edu.
authors.forename: Waleska M
authors.initials: WM
authors.lastname: Pabon-Ramos
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Niemeyer
authors.forename: Narasimham L
authors.initials: NL
authors.lastname: Dasika
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult