Percutaneous Access via the Recanalized Paraumbilical Vein for Varix Embolization in Seven Patients

ABSTRACT

OBJECTIVE: To evaluate the feasibility of percutaneous access via the recanalized paraumbilical vein for varix embolization. MATERIALS AND METHODS: Between July 2008 and Jan 2014, percutaneous access via the recanalized paraumbilical vein for varix embolization was attempted in seven patients with variceal bleeding. Paraumbilical vein puncture was performed under ultrasonographic guidance, followed by introduction of a 5-Fr sheath. We retrospectively evaluated the technical feasibility, procedure-related complications, and clinical outcomes of each patient. RESULTS: Recanalized paraumbilical vein catheterization was performed successfully in all patients. Gastroesophageal varix embolization was performed in six patients, and umbilical varix embolization was performed in one patient. Embolic materials used are N-butyl cyanoacrylate (n = 6) and coil with N-butyl cyanoacrylate (n = 1). There were no procedure-related complications. One patient underwent repeated variceal embolization 6 hours after initial procedure via recanalized paraumbilical vein, due to rebleeding from gastric varix. CONCLUSION: Percutaneous access via the paraumbilical vein for varix embolization is a simple alternative in patients with portal hypertension.