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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(01): 03-10
DOI: 10.1055/s-0041-1723061
Original Article

The Promise of Percutaneous Transhepatic Variceal Embolization for Both Gastroesophageal and Ectopic Varices—An Australian Case Series

Chaitanya Ambati 
1   Department of Medical Imaging, St Vincent’s Hospital, Sydney, Australia
,
Mark Danta
2   Department of Gastroenterology, St Vincent’s Hospital, Sydney, Australia
,
David Boshell
1   Department of Medical Imaging, St Vincent’s Hospital, Sydney, Australia
,
Jesse Ende
1   Department of Medical Imaging, St Vincent’s Hospital, Sydney, Australia
,
David Williams
2   Department of Gastroenterology, St Vincent’s Hospital, Sydney, Australia
,
Joga Chaganti 
1   Department of Medical Imaging, St Vincent’s Hospital, Sydney, Australia
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Abstract

Purpose This article aims to report Australian experience of percutaneous transhepatic embolization of gastroesophageal and ectopic varices.

Method Eight consecutive patients (mean age 61.8 years, 7 men) who had undergone percutaneous transhepatic variceal embolization (PTVE) for variceal bleeding between October 2013 and February 2020 were analyzed. All patients were admitted from the emergency department. The following embolic materials were used—coils, Onyx 18 (Medtronic), and n-butyl cyanoacrylate plus lipiodol.

Results Post-PTVE, all eight patients demonstrated clinical and radiological improvement in the immediate postprocedure period (< 24 hours). Patients were followed for a mean of 44 ± 24 days postprocedure. Two patients were lost to follow-up. The postprocedure complications included rebleeding (n = 1), hepatic encephalopathy (n = 1), hemoperitoneum (n = 1), ileus (n = 1), and abdominal pain (n = 3).

Conclusion PTVE is an effective treatment option for patients with uncontrolled variceal bleeding (ectopic as well as gastroesophageal) especially when the traditional therapies such as transjugular intrahepatic portosystemic shunts, endoscopic variceal ligation, and balloon-occluded retrograde transvenous obliteration are contraindicated or ineffective.

Keywords

portal hypertension - transhepatic - embolization


Publication History

Article published online:
25 January 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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