title: Comparison of percutaneous transhepatic variceal embolization (PTVE) followed by partial splenic embolization versus PTVE alone for the treatment of acute esophagogastric variceal massive hemorrhage.
abstract: OBJECTIVE
  To compare the efficacy of percutaneous transhepatic variceal embolization (PTVE) followed by partial splenic embolization (PSE) with that of PTVE alone for the treatment of acute massive hemorrhage of esophagogastric varices in patients with cirrhosis unable to undergo alternative procedures.
  
  
  METHODS
  Sixty-five patients with acute variceal massive hemorrhage were retrospectively studied, including 31 who underwent PTVE/PSE and 34 who underwent PTVE and refused PSE. Recurrent bleeding rate, survival rate, postoperative complications, number of days of hospitalization after PTVE, and outcome were evaluated. Peripheral blood cell counts and hemoglobin levels before and at 1 week and 6, 12, and 24 months after intervention were analyzed.
  
  
  RESULTS
  Cumulative recurrent bleeding rates at 6, 12, and 24 months after intervention in the PTVE/PSE group were 3.2%, 6.7%, and 13.3%, compared with 20.6%, 36.7%, and 53.6%, respectively, in the PTVE group; the difference at each time point was statistically significant (all P < .01). There were more cases of ascites and portal hypertensive gastropathy after PTVE than after PTVE/PSE (P < .05). Survival rates at 6, 12, and 24 months in the PTVE/PSE group were 100%, 96.8%, and 96.8%, compared with 94.1%, 88.2%, and 82.4%, respectively, in the PTVE group. There were significant differences in peripheral blood cell counts and hemoglobin levels between the PTVE/PSE and PTVE groups at all observed time points (all P < .01).
  
  
  CONCLUSIONS
  PTVE/PSE not only has long-term efficacy in alleviating hypersplenism, but decreases recurrent bleeding and maintains hepatic reserve in patients with cirrhosis and esophagogastric variceal massive hemorrhage unable to undergo other procedures.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.. Electronic address: hanxinwei2006@163.com.
authors.forename: XuHua
authors.initials: X
authors.lastname: Duan
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: XinWei
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: JianZhuang
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: Miao
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: GuoHao
authors.initials: G
authors.lastname: Huang
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 East Jian She Rd., Zhengzhou 450052, Henan Province, People's Republic of China.
authors.forename: MengFan
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000628:therapy*; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000628:therapy*; D006975:Hypertension, Portal / Q000150:complications; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome