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Esophageal variceal stent

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https://www.readbyqxmd.com/read/27875848/multimodal-therapy-of-recurrent-and-refractory-bleeding-from-esophageal-varices-case-report-and-review-of-the-literature
#1
Matthias Buechter, Volker Penndorf, Ali Canbay, Jens M Theysohn, Alexander Dechêne
Bleeding from esophageal varices is a major cause of mortality in patients with advanced liver disease. Although standard treatment and secondary prophylaxis are effective, in some patients sustained hemostasis cannot be achieved. We report the case of a woman with alcoholic liver disease in whom pharmacological, endoscopic, and intravascular therapies failed to control variceal bleeding. Only a combination of (repeated) band ligation, insertion of a self-expanding metal stent, TIPS implantation and redilatation, transjugular variceal embolization, and finally implantation of a portocaval shunt proved to be successful...
November 22, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27723988/-late-complications-of-liver-cirrhosis-management-of-gastrointestinal-bleeding-in-the-presence-of-portal-hypertension
#2
Václav Hejda
Cirrhosis is the end stage of progressive development of different liver diseases and is associated with significant morbidity and mortality rates. Cirrhosis is associated with a number of potential complications, in particular with development of portal hypertension. Portal hypertension with the production of ascites, hepatic and gastric varices bleeding in the upper part of the gastrointestinal tract, presents the breakpoint in the natural course of cirrhosis, and it is associated with a considerably worse prognosis of patients, with a dramatically increased risk of mortality...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27689206/therapeutic-challenges-for-symptomatic-portal-cavernoma-cholangiopathy
#3
Adriana Cavași, Voicu Mercea, Ofelia Anton, Ion Cosmin Puia
Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27626318/esophageal-stenting-for-benign-and-malignant-disease-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#4
Manon C W Spaander, Todd H Baron, Peter D Siersema, Lorenzo Fuccio, Brigitte Schumacher, Àngels Escorsell, Juan-Carlos Garcia-Pagán, Jean-Marc Dumonceau, Massimo Conio, Antonella de Ceglie, Janusz Skowronek, Marianne Nordsmark, Thomas Seufferlein, André Van Gossum, Cesare Hassan, Alessandro Repici, Marco J Bruno
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence)...
October 2016: Endoscopy
https://www.readbyqxmd.com/read/27517043/esophageal-stent-for-refractory-variceal-bleeding-a-systemic-review-and-meta-analysis
#5
REVIEW
Xiao-Dong Shao, Xing-Shun Qi, Xiao-Zhong Guo
Background. Preliminary studies suggest that covered self-expandable metal stents may be helpful in controlling esophageal variceal bleeding. Aims. To evaluate the effectiveness and safety of esophageal stent in refractory variceal bleeding in a systematic review and meta-analysis. Methods. A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 1970 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27429715/could-there-be-light-at-the-end-of-the-tunnel-mesocaval-shunting-for-refractory-esophageal-varices-in-patients-with-contraindications-to-transjugular-intrahepatic-portosystemic-shunt
#6
REVIEW
Jessica Davis, Albert K Chun, Marie L Borum
Cirrhotic patients with recurrent variceal bleeds who have failed prior medical and endoscopic therapies and are not transjugular intrahepatic portosystemic shunt candidates face a grim prognosis with limited options. We propose that mesocaval shunting be offered to this group of patients as it has the potential to decrease portal pressures and thus decrease the risk of recurrent variceal bleeding. Mesocaval shunts are stent grafts placed by interventional radiologists between the mesenteric system, most often the superior mesenteric vein, and the inferior vena cava...
July 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27205898/deflating-balloon-tamponade-should-we-expand-the-use-of-stents-for-severe-refractory-esophageal-variceal-bleeding
#7
EDITORIAL
Loren Laine
No abstract text is available yet for this article.
June 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27127576/transjugular-intrahepatic-portosystemic-shunt-occlusion-complicated-with-biliary-fistula-successfully-treated-with-a-stent-graft-a-case-report
#8
Eunyoung Kim, Sung Won Lee, Woo Hyeon Kim, Si Hyun Bae, Nam Ik Han, Jung Suk Oh, Ho Jong Chun, Hae Giu Lee
A 43-year-old man with liver cirrhosis received transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of recurrent variceal bleeding and F3 esophageal varices. During routine follow up liver ultrasound examination, six months after the implantation, TIPS occlusion was suspected and TIPS revision was performed. During the revision, moderate to severe stenosis at the hepatic venous segment of the tract and a total occlusion at the parenchymal segment of TIPS tract near the portal vein with biliary-TIPS fistula were identified with a clear visualization of the common bile duct...
January 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/26989521/a-rare-but-reversible-cause-of-hematemesis-downhill-esophageal-varices
#9
Lam-Phuong Nguyen, Narin Sriratanaviriyakul, Christian Sandrock
"Downhill" varices are a rare cause of acute upper gastrointestinal bleeding and are generally due to obstruction of the superior vena cava (SVC). Often these cases of "downhill" varices are missed diagnoses as portal hypertension but fail to improve with medical treatment to reduce portal pressure. We report a similar case where recurrent variceal bleeding was initially diagnosed as portal hypertension but later found to have SVC thrombosis presenting with recurrent hematemesis. A 39-year-old female with history of end-stage renal disease presented with recurrent hematemesis...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/26948179/an-update-on-the-management-of-acute-esophageal-variceal-bleeding
#10
Lourdes Cabrera, Puneeta Tandon, Juan G Abraldes
The mortality rate in acute variceal haemorrhage remains high (around 15%). Treatment is based on the combined use of vasoactive drugs, endoscopic band ligation, and prophylactic antibiotics. Effective resuscitation (haemostasis, volume management) is essential to prevent complications. Treatment failure is best managed by transjugular intrahepatic portosystemic shunt (TIPS). Balloon tamponade or specifically designed covered oesophageal stents can be used as a bridge to definitive therapy in unstable patients...
March 2, 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/26845490/self-expanding-metal-stents-for-acute-refractory-esophageal-variceal-bleeding-a-systematic-review-and-meta-analysis
#11
Thomas R McCarty, Basile Njei
BACKGROUND AND AIM: Esophageal variceal bleeding is a severe complication of portal hypertension with significant morbidity and mortality. A substantial portion of cirrhotics fail to respond to conventional medical therapy and band ligation, necessitating alternative treatments including self-expanding metal stent (SEMS) placement for acute refractory esophageal variceal bleeding. In the present study, we carried out a systematic review and structured meta-analysis of all eligible studies to evaluate the technical feasibility, safety, clinical efficacy, and survival advantage of SEMS placement for the treatment of of acute esophageal variceal bleeding...
July 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/26804426/current-approaches-to-the-management-of-patients-with-liver-cirrhosis-who-have-acute-esophageal-variceal-bleeding
#12
REVIEW
Dmitry Victorovich Garbuzenko
OBJECTIVE: Esophageal variceal bleeding is the most dangerous complication in patients with liver cirrhosis, and it is accompanied by high mortality. Their treatment can be complex, and requires a multidisciplinary approach. This review examines current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding. METHODS: PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1987 and 2015...
2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/26744608/hemostasis-in-uncontrolled-esophageal-variceal-bleeding-by-self-expanding-metal-stents-a-systematic-review
#13
REVIEW
Stefano Pontone, Michela Giusto, Angelo Filippini, Clelia Cicerone, Daniele Pironi, Manuela Merli
AIM: The aim of this systematic review was to evaluate the current reported efficacy and the mortality rate of SEMS treatment in uncontrolled bleeding patients. BACKGROUND: Esophageal variceal bleeding (EVB) represents a life threatening pathology. Despite the adequate pharmacologic and endoscopic treatment, continuous or recurrent bleeding, named as uncontrolled bleeding, occurs in 10-20% of cases. A new removable, covered, and self-expanding metal stent (SEMS) was proposed to control the variceal bleeding...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/26649098/intraoperative-salvage-endoscopy-performed-during-orthotopic-liver-transplantation-due-to-esophageal-bleeding
#14
Konrad Kobryn, Sławomir Kozieł, Waldemar Patkowski, Michał Grąt, Tadeusz Wróblewski, Marek Krawczyk
INTRODUCTION: Liver transplantation (LTx) is a widely accepted method of treatment for end stage liver diseases. There are many reports on the management of gastrointestinal bleeding (GIB) after LTx, however the number of studies concerning salvage endoscopic procedures during LTx are scarce. AIM: We present our material of intraoperative endoscopic procedures due to GIB during LTx. MATERIAL AND METHODS: During this period there were 4 females and 1 male at the mean age of 52...
September 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/26604651/combined-transjugular-intrahepatic-portosystemic-shunt-and-other-interventions-for-hepatocellular-carcinoma-with-portal-hypertension
#15
Bin Qiu, Meng-Fei Zhao, Zhen-Dong Yue, Hong-Wei Zhao, Lei Wang, Zhen-Hua Fan, Fu-Liang He, Shan Dai, Jian-Nan Yao, Fu-Quan Liu
AIM: To evaluate combination transjugular intrahepatic portosystemic shunt (TIPS) and other interventions for hepatocellular carcinoma (HCC) and portal hypertension. METHODS: Two hundred and sixty-one patients with HCC and portal hypertension underwent TIPS combined with other interventional treatments (transarterial chemoembolization/transarterial embolization, radiofrequency ablation, hepatic arterio-portal fistulas embolization, and splenic artery embolization) from January 1997 to January 2010 at Beijing Shijitan Hospital...
November 21, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/26600191/esophageal-balloon-tamponade-versus-esophageal-stent-in-controlling-acute-refractory-variceal-bleeding-a-multicenter-randomized-controlled-trial
#16
Àngels Escorsell, Oana Pavel, Andrés Cárdenas, Rosa Morillas, Elba Llop, Càndid Villanueva, Juan C Garcia-Pagán, Jaime Bosch
UNLABELLED: Balloon tamponade is recommended only as a "bridge" to definitive therapy in patients with cirrhosis and massive or refractory esophageal variceal bleeding (EVB), but is frequently associated with rebleeding and severe complications. Preliminary, noncontrolled data suggest that a self-expandable, esophageal covered metal stent (SX-ELLA Danis; Ella-CS, Hradec Kralove, Czech Republic) may be an effective and safer alternative to balloon tamponade. We conducted a randomized, controlled trial aimed at comparing esophageal stent versus balloon tamponade in patients with cirrhosis and EVB refractory to medical and endoscopic treatment...
June 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/26159269/therapies-drugs-scopes-and-transjugular-intrahepatic-portosystemic-shunt-when-and-how
#17
Juan G Abraldes, Puneeta Tandon
Variceal bleeding is the most serious complication of portal hypertension. All cirrhotic patients should be screened endoscopically for varices which are present in about 30% of compensated and 60% of decompensated patients at diagnosis. In patients without varices, endoscopy surveillance should be continued every 2 years. Patients with high-risk varices (moderate or large in size, or with red color signs, or in Child-Pugh C patients) should be treated with a nonselective β-blocker to prevent bleeding (propranolol, nadolol or carvedilol)...
2015: Digestive Diseases
https://www.readbyqxmd.com/read/26135091/is-there-a-role-for-stenting-in-case-of-acute-esophageal-variceal-bleeding
#18
Gilles Lesur
No abstract text is available yet for this article.
December 2014: Endoscopy International Open
https://www.readbyqxmd.com/read/26133816/-safety-and-clinical-efficacy-of-tips-with-various-stents-for-treatment-of-cirrhosis-with-esophageal-gastric-varices-bleeding
#19
Wei Cai, Yuzheng Zhuge, Jianwu Zhang, Zhenlei Li, Qibin He, Ming Zhang, Jingbin Ni, Yujiang Li, Qianyun Ma, Chunyan Peng
OBJECTIVE: To assess the safety and clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with various stents for treating patients with cirrhosis and esophageal gastric varices bleeding. METHODS: One hundred and five patients were stratified according to stent type: bare stent group, covered stent-grafts group, combined stents group. Rates of success, shunt insufficiency, rebleeding, patient survival, and major complications were observed. The shunt insufficiency rate, rebleeding rate, and survival rate were calculated by the life tables method, the Kaplan-Meier analytical curve, and the log-rank test; a p-value less than 0...
April 2015: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/26098635/self-expandable-metal-stents-for-persisting-esophageal-variceal-bleeding-after-band-ligation-or-injection-therapy-a-retrospective-study
#20
Martin Müller, Thomas Seufferlein, Lukas Perkhofer, Martin Wagner, Alexander Kleger
BACKGROUND AND STUDY AIMS: Despite a pronounced reduction of lethality rates due to upper gastrointestinal bleeding, esophageal variceal bleeding remains a challenge for the endoscopist and still accounts for a mortality rate of up to 40% within the first 6 weeks. A relevant proportion of patients with esophageal variceal bleeding remains refractory to standard therapy, thus making a call for additional tools to achieve hemostasis. Self-expandable metal stents (SEMS) incorporate such a tool...
2015: PloS One
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