J Korean Radiol Soc.
1986 Oct;22(5):672-682. 10.3348/jkrs.1986.22.5.672.
Percutaneous transhepatic variceal obliteration
- KMID: 2462268
- DOI: http://doi.org/10.3348/jkrs.1986.22.5.672
Abstract
- Pecutaneous transhepatic portogram with selective catheterizatio of the portal vein and its tributaries notonly provide information about the status of portal circulation and but can also be used in the treatment ofbleeding esophageal varices by selective embolization with various embolic materials. The authors describe easierand safer modified method of conventional percutaneous transhepatic portogram. We wish to describe our experiencewith the technical aspects and portosystemic collateral patterns in 26 patients with variceal bleeding, from July1985 to July 1986 at Kyungpook National University Hospital. 1. To overcome the difficulties of catheter passageand superselection of variceal supplying vein, we used 7F sheath directly introduced over the ,018"³ guide wire.We used coaxial system using 25cm 18G needle within 7F vessel dilator to make the tip of dilator more rigid. 2.Variceal obliteration attempted in 23 patients who showed variceal supplying veins on the protogram, Successfulobilteration was obtained in 20 patients. We used absolute ethanol, stainless steel coil, and Gelfoam cubes withsclerosing and embolica agent of variceal vein. 3. Portosystemic collaterals of 24 patients; Coronary vein;21cases, Inferior mesenteric vein:9 cases, Short gastric vein:7 cases, Umbilical & paraumbilical vein; 6 cases,Gastrorenal: 3 cases, Splenorenal: 2 cases, Splenoretoperitoneal: 1 case. 4. The number of coronay vein were 18cases of single and 4 cases of two. The locations of coronary vein: Splenic vein: 13 cases, Main portal vein: 7cases, Junctional area: 6 cases. 5. Transhepatic obliteration of the gastroesophageal veins is a relatively simpleand usually successful form of palliative treatment for actively bleeding and stable gastroesophageal varices.
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