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Endoscopic management of gastric variceal bleeding.
Gastroenterol Clin North Am. 2014 Dec; 43(4):807-18.GC

Abstract

Expert knowledge of endoscopic management of gastric varices is essential, as these occur in 20% of patients with portal hypertension. Bleeding is relatively uncommon, but carries significant mortality when this occurs. Inability to directly target intravascular injections and the potential complication related to glue embolization has resulted in the development of novel techniques. Direct visualization of the varix lumen using endoscopic ultrasound (EUS) allows targeted therapy of feeder vessels with real-time imaging. EUS-guided combination therapy with endovascular coiling and cyanoacrylate injections promise to provide reduced complication rates, increased obliteration of varices, and reduced long-term rebleeding rates.

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linkinghub.elsevier.com
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Authors+Show Affiliations

Weilert F
Department of Gastroenterology, Waikato Hospital, Pembroke Street, Hamilton 2001, New Zealand.
Binmoeller KF
Interventional Endoscopy Services, California Pacific Medical Center, 2351 Clay Street, 6th Floor, San Francisco, CA 94115, USA. Electronic address: BinmoeK@sutterhealth.org.

MeSH

AdhesivesBalloon OcclusionCyanoacrylatesEmbolization, TherapeuticEndoscopy, GastrointestinalEndosonographyEsophageal and Gastric VaricesGastrointestinal HemorrhageHemostasis, EndoscopicHumansUltrasonography, Interventional

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25440927

Citation

Weilert, Frank, and Kenneth F. Binmoeller. "Endoscopic Management of Gastric Variceal Bleeding." Gastroenterology Clinics of North America, vol. 43, no. 4, 2014, pp. 807-18.
Weilert F, Binmoeller KF. Endoscopic management of gastric variceal bleeding. Gastroenterol Clin North Am. 2014;43(4):807-18.
Weilert, F., & Binmoeller, K. F. (2014). Endoscopic management of gastric variceal bleeding. Gastroenterology Clinics of North America, 43(4), 807-18. https://doi.org/10.1016/j.gtc.2014.08.010
Weilert F, Binmoeller KF. Endoscopic Management of Gastric Variceal Bleeding. Gastroenterol Clin North Am. 2014;43(4):807-18. PubMed PMID: 25440927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic management of gastric variceal bleeding. AU - Weilert,Frank, AU - Binmoeller,Kenneth F, Y1 - 2014/09/12/ PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/7/23/medline KW - Coil embolization KW - Cyanoacrylate KW - Endoscopic ultrasound KW - Gastric varices SP - 807 EP - 18 JF - Gastroenterology clinics of North America JO - Gastroenterol Clin North Am VL - 43 IS - 4 N2 - Expert knowledge of endoscopic management of gastric varices is essential, as these occur in 20% of patients with portal hypertension. Bleeding is relatively uncommon, but carries significant mortality when this occurs. Inability to directly target intravascular injections and the potential complication related to glue embolization has resulted in the development of novel techniques. Direct visualization of the varix lumen using endoscopic ultrasound (EUS) allows targeted therapy of feeder vessels with real-time imaging. EUS-guided combination therapy with endovascular coiling and cyanoacrylate injections promise to provide reduced complication rates, increased obliteration of varices, and reduced long-term rebleeding rates. SN - 1558-1942 UR - https://www.unboundmedicine.com/medline/citation/25440927/Endoscopic_management_of_gastric_variceal_bleeding_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-8553(14)00100-9 DB - PRIME DP - Unbound Medicine ER -