A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy

Tawfik Khoury, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Nicholas Ludvik, Alan Schumann, Mahmud Mahamid, Meir Mizrahi

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Background Gastric varices (GV) manifest in almost one-fifth of the patients with portal hypertension. Although primary pharmacological prevention of esophageal varices has been identified, there are limited therapeutic options that are optimal for GV bleeding. Recently, the use of endoscopic ultrasound (EUS)-guided angiotherapy [cyanoacrylate (CA) and coils] was introduced for the treatment of GV. Although CA injection is the recommended first-line therapeutic modality, it is associated with systemic, life-threatening embolization as well as technical instrumental challenges. Recently, EUS-guided coiling for GV was used with high safety profile. Methods This is a review of the current literature on the treatment of GV, focusing on the role of EUS-guided angiotherapy in the treatment of GV. We performed a Medline/PubMed search, and 37 relevant studies were extracted and examined. Results EUS-guided angiotherapy has shown a consistent favorable result among the several reports throughout the literature, with better safety and efficacy profile toward EUS-guided coiling; however, a combination treatment with EUS-guided coiling followed by glue injection has shown as well to reduce the embolization adverse events associated with glue injection. Conclusion EUS-guided angiotherapy and specifically EUS-guided coiling is an emerging promising technique and should be considered as a first-line therapeutic option for bleeding GV.

Original languageEnglish
Pages (from-to)1411-1415
Number of pages5
JournalEuropean Journal of Gastroenterology and Hepatology
Volume30
Issue number12
DOIs
StatePublished - 1 Dec 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • coiling
  • cyanoacrylate
  • endoscopic ultrasound
  • gastric varices

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