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Transhepatic embolization of varices

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Abstract

Percutaneous transhepatic embolization of varices (PTEV) has proved to be effective in the control variceal bleeding, particularly in Child's Class C Category patients whose bleeding was not adequately controlled by pitressin perfusions. PTEV, using Gelfoam soaked in sodium tetradecyl sulfate, controlled acute variceal bleeding in 71–95% of patients and appears to be more effective as an embolizing agent than bucrylate, which controlled 43–57%.

Considering the poor condition of the patients particularly during acute bleeding episodes, PTEV is a relatively safe therapeutic procedure that buys time for the surgeons to perform a decompressive shunt electively as definitive surgery. A one-year recurrent bleeding rate of 30% and a two year recurrence of 37.5% was noted. Thus, for long term control of variceal bleeding, a surgical decompressive shunt is recommended in addition to PTEV.

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Authors and Affiliations

  1. Department of Radiology, Boston Veterans Administration Hospital Center, 150S. Huntington Ave., 02130, Jamaica Plain, MA, USA

    Warren C. Widrich M.D. & Alan H. Robbins

  2. Department of Surgery, Tufts University School of Medicine, Boston, Massachusetts, USA

    Donald C. Nabseth

Authors
  1. Warren C. Widrich M.D.
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  2. Alan H. Robbins
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  3. Donald C. Nabseth
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Widrich, W.C., Robbins, A.H. & Nabseth, D.C. Transhepatic embolization of varices. Cardiovasc Intervent Radiol 3, 298–303 (1980). https://doi.org/10.1007/BF02552748

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