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Digestive Disease Interventions 2022; 06(02): 094-103
DOI: 10.1055/s-0041-1742100
Review Article

Variceal Hemorrhage: Decompression, Obliteration, or Both?

Benjamin J. McCafferty 
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Husamedin El Khudari 
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Aliaksei Salei 
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Andrew J. Gunn 
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
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Abstract

Variceal hemorrhage is a morbid condition that frequently mandates the involvement of interventional radiology to achieve successful and sustained hemostasis. Primary image-guided therapies for variceal hemorrhage include a transjugular intrahepatic portosystemic shunt and transvenous obliteration. Knowledge of variceal pathophysiology and anatomy, current techniques, and the evidence supporting therapeutic selection is paramount to successful patient outcomes. The purpose of this review is to provide the reader a framework of the available literature on image-guided management of bleeding varices to assist in clinical management.

Keywords

portal hypertension - variceal hemorrhage - transjugular intrahepatic portosystemic shunt - balloon-occluded retrograde transvenous obliteration - cirrhosis

Disclosures

A.J.G. is a speaker for Boston Scientific and Terumo, is a consultant for Varian and Boston Scientific, and receives research support from Penumbra.




Publication History

Received: 05 July 2021

Accepted: 24 November 2021

Article published online:
04 January 2022

© 2022. Thieme. All rights reserved.

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