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GI Endoscopic Emergencies pp 181–193Cite as

Hemostasis of Acute Gastric Variceal Bleeding

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Abstract

Gastric variceal hemorrhage is one of the most dreaded endoscopic emergencies. Optimal management recommendations are limited by the lack of robust evidence-based data. Although endoscopic band ligation and sclerotherapy are effective modalities for esophageal variceal bleeding, they are suboptimal therapies for fundal variceal hemorrhage. Endoscopic cyanoacrylate injection is considered a first-line treatment option, where available. The role of EUS-guided angiotherapy for gastric variceal bleeding is promising. Non-endoscopic treatment options include transjugular intrahepatic portosystemic shunt and balloon-occluded retrograde transvenous obliteration. There is a need for prospective comparative studies among the various treatment modalities to further define optimal management algorithms for gastric variceal hemorrhage.

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Authors and Affiliations

  1. Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, 2351 Clay Street; 6th Floor Stanford Building, Suite 600, San Francisco, CA, 94105, USA

    Chris Hamerski M.D., Kenneth F. Binmoeller M.D. & Janak N. Shah M.D.

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  1. Chris Hamerski M.D.
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  2. Kenneth F. Binmoeller M.D.
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  3. Janak N. Shah M.D.
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Corresponding author

Correspondence to Janak N. Shah M.D. .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

    Louis M. Wong Kee Song

  2. Medical College of Wisconsin-Green Bay Campus, Prevea Center for Digestive Health, Green Bay, Wisconsin, USA

    Emmanuel C. Gorospe

  3. Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA

    Todd H. Baron

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Endoscopic band ligation for bleeding gastroesophageal varices type 1 (GOV1) (MP4 22524 kb)

Technique of 2-octyl cyanoacrylate injection for fundal varices with stigmata of recent bleeding (MP4 21226 kb)

Actively bleeding fundal varix treated with cyanoacrylate injection (MP4 7390 kb)

Animation of balloon-occluded retrograde transvenous obliteration (BRTO) procedure for treatment of gastric varices (MP4 6488 kb)

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Hamerski, C., Binmoeller, K.F., Shah, J.N. (2016). Hemostasis of Acute Gastric Variceal Bleeding. In: Wong Kee Song, L., Gorospe, E., Baron, T. (eds) GI Endoscopic Emergencies. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3085-2_13

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