Interventional procedure overview of transvenous obliteration for gastric varices

Study type

Retrospective, single centre, case series

Country

China

Recruitment period

2003 to 2009

Study population and number

n=73 (71 followed up)

People with acute or recent gastric varices bleeding who had percutaneous transhepatic obliteration.

Age and sex

Mean 50.3 years; 62% male

Patient selection criteria

Inclusion criteria: acute gastric variceal bleeding or a history of gastric variceal bleeding within 6 months of hospital admission.

Exclusion criteria: serum bilirubin level of more than 100 mg/L, serum creatinine value of greater than 2 mg/dL, platelet count of less than 20,000/mm³, complete obstruction of the portal vein because of thrombosis, hepatic encephalopathy greater than stage II, hepatorenal syndrome, and cardiorespiratory failure.

Technique

Percutaneous transhepatic obliteration under local anaesthesia. Percutaneous transhepatic puncture of the intrahepatic branch of the portal vein was performed. Splenoportography was done to evaluate the gastric varices, the feeding veins, and the draining veins.

In people without large gastrorenal shunts, cyanoacrylate was injected directly into the gastric varices. For people with large gastrorenal shunts, a balloon catheter was inserted into the left renal vein via the right femoral vein to reduce the gastrorenal shunt blood flow. Afterward, cyanoacrylate was injected into the gastric varices.

Follow up

Mean 24.2 months (SD 12.4 months)

Conflict of interest/source of funding

Conflict of interest: Not reported.

Source of funding: Not reported.