Tags

Type your tag names separated by a space and hit enter

Ectopic varices in the gastrointestinal tract: short- and long-term outcomes of percutaneous therapy.
Cardiovasc Intervent Radiol. 2005 Mar-Apr; 28(2):178-84.CI

Abstract

To evaluate the results of percutaneous management of ectopic varices, a retrospective review was carried out of 14 patients (9 men, 5 women; mean age 58 years) who between 1992 and 2001 underwent interventional radiological techniques for management of bleeding ectopic varices. A history of prior abdominal surgery was present in 12 of 14 patients. The interval between the surgery and percutaneous intervention ranged from 2 to 38 years. Transhepatic portal venography confirmed ectopic varices to be the source of portal hypertension-related gastrointestinal bleeding. Embolization of the ectopic varices was performed by a transhepatic approach with coil embolization of the veins draining into the ectopic varices. Transjugular intrahepatic portosystemic shunt (TIPS) was performed in the standard fashion. Eighteen procedures (12 primary coil embolizations, 1 primary TIPS, 2 re-embolizations, 3 secondary TIPS) were performed in 13 patients. One patient was not a candidate for percutaneous treatment. All interventions but one (re-embolization) were technically successful. In 2 of 18 interventions, re-bleeding occurred within 72 hr (both embolization patients). Recurrent bleeding (23 days to 27 months after initial intervention) was identified in 9 procedures (8 coil embolizations, 1 TIPS due to biliary fistula). One patient had TIPS revision because of ultrasound surveillance findings. New encephalopathy developed in 2 of 4 TIPS patients. Percutaneous coil embolization is a simple and safe treatment for bleeding ectopic varices; however, recurrent bleeding is frequent and reintervention often required. TIPS can offer good control of bleeding at the expense of a more complex procedure and associated risk of encephalopathy.

Authors+Show Affiliations

Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA. macedo.thanila@mayo.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15719183

Citation

Macedo, Thanila A., et al. "Ectopic Varices in the Gastrointestinal Tract: Short- and Long-term Outcomes of Percutaneous Therapy." Cardiovascular and Interventional Radiology, vol. 28, no. 2, 2005, pp. 178-84.
Macedo TA, Andrews JC, Kamath PS. Ectopic varices in the gastrointestinal tract: short- and long-term outcomes of percutaneous therapy. Cardiovasc Intervent Radiol. 2005;28(2):178-84.
Macedo, T. A., Andrews, J. C., & Kamath, P. S. (2005). Ectopic varices in the gastrointestinal tract: short- and long-term outcomes of percutaneous therapy. Cardiovascular and Interventional Radiology, 28(2), 178-84.
Macedo TA, Andrews JC, Kamath PS. Ectopic Varices in the Gastrointestinal Tract: Short- and Long-term Outcomes of Percutaneous Therapy. Cardiovasc Intervent Radiol. 2005 Mar-Apr;28(2):178-84. PubMed PMID: 15719183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ectopic varices in the gastrointestinal tract: short- and long-term outcomes of percutaneous therapy. AU - Macedo,Thanila A, AU - Andrews,James C, AU - Kamath,Patrick S, PY - 2005/2/19/pubmed PY - 2005/6/2/medline PY - 2005/2/19/entrez SP - 178 EP - 84 JF - Cardiovascular and interventional radiology JO - Cardiovasc Intervent Radiol VL - 28 IS - 2 N2 - To evaluate the results of percutaneous management of ectopic varices, a retrospective review was carried out of 14 patients (9 men, 5 women; mean age 58 years) who between 1992 and 2001 underwent interventional radiological techniques for management of bleeding ectopic varices. A history of prior abdominal surgery was present in 12 of 14 patients. The interval between the surgery and percutaneous intervention ranged from 2 to 38 years. Transhepatic portal venography confirmed ectopic varices to be the source of portal hypertension-related gastrointestinal bleeding. Embolization of the ectopic varices was performed by a transhepatic approach with coil embolization of the veins draining into the ectopic varices. Transjugular intrahepatic portosystemic shunt (TIPS) was performed in the standard fashion. Eighteen procedures (12 primary coil embolizations, 1 primary TIPS, 2 re-embolizations, 3 secondary TIPS) were performed in 13 patients. One patient was not a candidate for percutaneous treatment. All interventions but one (re-embolization) were technically successful. In 2 of 18 interventions, re-bleeding occurred within 72 hr (both embolization patients). Recurrent bleeding (23 days to 27 months after initial intervention) was identified in 9 procedures (8 coil embolizations, 1 TIPS due to biliary fistula). One patient had TIPS revision because of ultrasound surveillance findings. New encephalopathy developed in 2 of 4 TIPS patients. Percutaneous coil embolization is a simple and safe treatment for bleeding ectopic varices; however, recurrent bleeding is frequent and reintervention often required. TIPS can offer good control of bleeding at the expense of a more complex procedure and associated risk of encephalopathy. SN - 0174-1551 UR - https://www.unboundmedicine.com/medline/citation/15719183/Ectopic_varices_in_the_gastrointestinal_tract:_short__and_long_term_outcomes_of_percutaneous_therapy_ L2 - https://dx.doi.org/10.1007/s00270-004-0148-8 DB - PRIME DP - Unbound Medicine ER -