title: Gastroesophageal Variceal Filling and Drainage Pathways: An Angiographic Description of Afferent and Efferent Venous Anatomic Patterns.
abstract: Varices commonly occur in liver cirrhosis patients and are classified as esophageal (EV), gastroesophageal (GEV), or isolated gastric (IGV) varices. These vessels may be supplied and drained by several different afferent and efferent pathways. A working knowledge of variceal anatomy is imperative for Interventional Radiologists performing transjugular intrahepatic portosystemic shunt and embolization/obliteration procedures. This pictorial essay characterizes the angiographic anatomy of varices in terms of type and frequency of venous filling and drainage, showing that different varices have distinct vascular anatomy. EVs typically show left gastric vein filling and "uphill" drainage, and GEVs and IGVs exhibit additional posterior/short gastric vein contribution and "downhill" outflow. An understanding of these variceal filling and drainage pathways can facilitate successful portal decompression and embolization/obliteration procedures.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Gaba
authors.affiliation: University of Illinois College of Medicine, Chicago, Illinois, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Couture
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA.
authors.forename: Janesh
authors.initials: J
authors.lastname: Lakhoo
keywords: Anatomy; gastroesophageal varices; portal hypertension; transjugular intrahepatic portosystemic shunt