Open AccessEndoscopic Ultrasound‐Guided Angiotherapy for Gastric Varices: A Single Center Experience
Author(s) -
Khoury Tawfik,
Massarwa Muhammad,
Daher Saleh,
Benson Ariel A.,
Hazou Wadi,
Israeli Eran,
Jacob Harold,
Epstein Julia,
Safadi Rifaat
Publication year - 2019
Publication title -
hepatology communications
Language(s) - English
Resource type - Journals
ISSN - 2471-254X
DOI - 10.1002/hep4.1289
Subject(s) - medicine , transjugular intrahepatic portosystemic shunt , gastric varices , cyanoacrylate , cirrhosis , portal hypertension , varices , endoscopic ultrasound , endoscopy , surgery , radiology , gastroenterology , chemistry , adhesive , organic chemistry , layer (electronics)
There are limited efficacious therapeutic options for management of gastric variceal bleeding. Treatment modalities include transjugular intrahepatic portosystemic shunt, surgical shunts, and endoscopic interventions, including the recent advancement of endoscopic ultrasound (EUS)‐guided coiling. We present a case series of 10 patients with portal hypertension (7 with liver cirrhosis and 3 without cirrhosis), complicated by gastric varices (GV) with bleeding. All cases were treated successfully with EUS‐guided coiling leading to variceal eradication. There were 10 occurrences of minimal self‐limited bleeding at the puncture site during the procedure, and only one occurrence of major bleeding that necessitated cyanoacrylate glue injection for homeostasis. There were no other adverse events within a mean follow‐up time of 9.7 months (range, 1‐28 months). Conclusion: In our series, EUS‐guided angiotherapy was effective for GV eradication with a high safety profile.