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Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO

1
Department of Gastroenterology, School of Medicine, Istanbul Medipol University, Istanbul–34214, Turkey
2
Department of Gastroenterology, School of Medicine, Near East University, Nicosia-99138, Cyprus
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(7), 335; https://doi.org/10.3390/medicina55070335
Received: 12 December 2018 / Revised: 28 June 2019 / Accepted: 28 June 2019 / Published: 3 July 2019
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Abstract

Gastric varices are less common than esophageal varices, and their treatment is quite challenging. Gastric varix bleedings (GVB) occur less frequently than esophageal varix (EV) bleedings and represent 10to 30% of all variceal bleedings. They are; however, more severe and are associated with high mortality. Re-bleeding may occur in 35to 90% of cases after spontaneous hemostasis. GV bleedings represent a serious clinical problem compared with esophageal varices due to their location. Sclerotherapy and band ligation, in particular, are less effective. Based on the anatomic site and location, treatment differs from EV and is categorized into two groups (i.e., endoscopic or radiologic treatment). Surgical management is used less frequently. Balloon-occluded retrograde transvenous obliteration (BRTO) and cyanoacrylate are safe but there is a high risk of re-bleeding. Portal pressure elevates following BRTO and leads to worsening of esophageal varix pressure. Other significant complications may include hemoglobinuria, abdominal pain, fever, and pleural effusion. Shock and atrial fibrillation are major complications. New and efficient treatment modalities will be possible in the future. View Full-Text
Keywords: gastric varices; bleeding; glue and coil application; BRTO gastric varices; bleeding; glue and coil application; BRTO
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Goral, V.; Yılmaz, N. Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO. Medicina 2019, 55, 335.

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