The therapeutic effects of endoscopic ultrasound-guided coil embolization for gastric varices (with video) / 中华消化内镜杂志

ABSTRACT

Objective:To investigate the safety and efficacy of endoscopic ultrasound-guided coil embolization for gastric varices.Methods:Patients with portal hypertension who received endoscopic ultrasound-guided coil embolization for the prophylaxis of gastric variceal bleeding between November 2016 and August 2020 at Zhongshan Hospital, Fudan University were included in the study. The primary evaluation index was the post-operative loss of blood flow in gastric varices, and the secondary indices included the safety of coil embolization, rebleeding rate, portal vein thrombosis changes and patient survival.Results:A total of 13 patients with isolated gastric varices and portal systemic shunt were enrolled, including 6 males and 7 females with the median age of 58 years. The median maximum diameter of the target vessel was 40 mm and the median number of coils used was 2.7. All puncture sites were in the lower part of the esophagus near the cardia, and no active bleeding occurred after deployment of coils. Flow in the gastric varices were confirmed absent by Doppler imaging. In a median follow-up period of 403 days, 2 patients had rebleeding, with the one-year rebleeding rate of 9.1%.Two patients developed portal venous thrombosis after the operation. Two patients died, and the one-year survival rate was 90.0%.Conclusion:Endoscopic ultrasound-guided coil embolization might be an effective option for the treatment of isolated gastric varices with portal systemic shunts.