Prevention of variceal rebleeding - Approach to management

MedGenMed Medscape General Medicine

Volumn 5, Issue 2, 2003, Pages

  Mela, Maria ^a   Thalheimer, Ulrich ^a   Burroughs, Andrew ^a  

^a ROYAL FREE HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ADENOVIRUS VECTOR; ALCOHOL; ALPHA ADRENERGIC RECEPTOR BLOCKING AGENT; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIFIBROTIC AGENT; ARGON; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BOSENTAN; CAPTOPRIL; CARVEDILOL; CLONIDINE; CYANOACRYLATE; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; ENALAPRIL; ENDOTHELIN RECEPTOR ANTAGONIST; IRBESARTAN; ISOSORBIDE DINITRATE; ISOSORBIDE MONONITRATE; LOSARTAN; N ACETYLGLUCOSAMINE; NADOLOL; NITRIC OXIDE; OCTREOTIDE; PLACEBO; PRAZOSIN; PROPRANOLOL; SARALASIN; SEROTONIN ANTAGONIST; SPIRONOLACTONE; SUCRALFATE; UNINDEXED DRUG;

ALCOHOLISM; ARGON PLASMA COAGULATION; BRAIN EMBOLISM; CLINICAL TRIAL; DISEASE SEVERITY; DRUG POTENTIATION; ENDOSCOPIC SCLEROTHERAPY; ESOPHAGUS VARICES BLEEDING; HEMODYNAMIC MONITORING; HIGH RISK PATIENT; HUMAN; HYPOTENSION; KIDNEY FAILURE; LIVER CELL CARCINOMA; LIVER FAILURE; LIVER TRANSPLANTATION; LOW DRUG DOSE; META ANALYSIS; MORTALITY; NONHUMAN; PATHOGENESIS; PORTAL HYPERTENSION; PORTAL VEIN BLOOD PRESSURE; PORTOSYSTEMIC ANASTOMOSIS; RECURRENT DISEASE; RETROPERITONEAL ABSCESS; REVIEW; RISK ASSESSMENT; RISK FACTOR; STOMACH HEMORRHAGE; STOMACH VARICES; SURGICAL APPROACH; SURGICAL TECHNIQUE; SURVIVAL RATE; VEIN LIGATION; VIRAL GENE THERAPY; COMPARATIVE STUDY; ESOPHAGUS VARICES; FORECASTING; GASTROINTESTINAL HEMORRHAGE; PATHOPHYSIOLOGY;

ESOPHAGEAL AND GASTRIC VARICES; FORECASTING; GASTROINTESTINAL HEMORRHAGE; HUMANS; RECURRENCE;

EID: 25144520443     PISSN: None     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (154)

1. D'Amico G, Luca A. Natural history. Clinical-haemodynamic correlations. Prediction of the risk of bleeding. Baillieres Clin Gastroenterol. 1997;11:243-256.
2. D'Amico G, de Franchis R, Torri V. End-of-the-century reappraisal of the 6-week outcome of upper gastrointestinal bleeding in cirrhosis: a prospective study. Gastroenterology. 1999;116[suppl]:1199A.
3. de Franchis R, Primignani M. Why do varices bleed? Gastroenterol Clin North Am. 1992;2:85-101.
4. Moitinho E, Escorsell A, Bandi JC, et al. Prognostic value of early measurements of portal pressure in acute variceal bleeding. Gastroenterology. 1999;117:626-631.
5. Garcia-Tsao G, Groszmann RJ, Fisher RL, Conn HO, Atterbury CE, Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology. 1985;5:419-424.
6. D'amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology. 1995;22:332-354.
7. Groszmann RJ, Bosch J, Grace ND, et al. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology. 1990; 99:1401-1407.
8. Feu F, Garcia-Pagan JC, Bosch J, et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet. 1995; 346:1056-1059.
9. Garcia-Pagan JC, Escorsell A, Moitinho E, Bosch J. Influence of pharmacological agents on portal hemodynamics: basis for its use in the treatment of portal hypertension. Semin Liver Dis. 1999; 19:427-438.
10. Dawson J, Gertsch P, Mosimann F, West R, Elias E. Endoscopic variceal pressure measurements: response to isosorbide dinitrate. Gut. 1985;26:843-847.
11. Navasa M, Chesta J, Bosch J, Rodes J. Reduction of portal pressure by isosorbide-5-mononitrate in patients with cirrhosis. Effects on splanchnic and systemic hemodynamics and liver function. Gastroenterology. 1989;96:1110-1118.
12. Moreau R, Lebrec D. Nitrovasodilators and portal hypertension. J Hepatol. 1990;10:263-267.
13. Bernard B, Lebrec D, Mathurin P, Opolon P, Poynard T. Beta-adrenergic antagonists in the prevention of gastrointestinal rebleeding in patients with cirrhosis: a meta-analysis. Hepatology. 1997;25:63-70.
14. Groszmann RJ. Beta-adrenergic blockers and nitrovasodilators for the treatment of portal hypertension: the good, the bad, the ugly. Gastroenterology. 1997;113:1794-1797.
15. Garcia-Pagan JC, Feu F, Bosch J, Rodes J. Propranolol compared with propranolol plus isosorbide-5-mononitrate for portal hypertension in cirrhosis. A randomized controlled study. Ann Intern Med. 1991;114:869-873.
16. Vorobioff J, Picabea E, Gamen M, et al. Propranolol compared with propranolol plus isosorbide dinitrate in portal-hypertensive patients: long-term hemodynamic and renal effects. Hepatology. 1993;18:477-484.
17. Gournay J, Masliah C, Martin T, Perrin D, Galmiche JP. Isosorbide mononitrate and propranolol compared with propranolol alone for the prevention of variceal rebleeding. Hepatology. 2000;31:1239-1245.
18. Patti R, D'Amico G, Pasta L, Vizzini G, Traina M, Madonia S, Licata A. Isosorbide mononitrate (IMN) with nadolol compared to nadolol alone for prevention of recurrent bleeding in cirrhosis. A double-blond placebo-controlled randomised trial. J Hepatol. 1999;30[suppl]:81A.
19. Bureau C, Peron JM, Alric L, et al. "A La Carte" treatment of portal hypertension: Adapting medical therapy to hemodynamic response for the prevention of bleeding. Hepatology. 2002; 36:1361-1366.
20. Viallet A, Marleau D, Huet M, et al. Hemodynamic evaluation of patients with intrahepatic portal hypertension. Relationship between bleeding varices and the portohepatic gradient. Gastroenterology. 1975;69:1297-1300.
21. Nevens F, Bustami R, Scheys I, Lesaffre E, Fevery J. Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology. 1998;27:15-19.
22. Escorsell A, Bordas JM, Castaneda B, et al. Predictive value of the variceal pressure response to continued pharmacological therapy in patients with cirrhosis and portal hypertension. Hepatology. 2000;31:1061-1067.
23. Villanueva C, Balanzo J, Novella MT, et al. Nadolol plus isosorbide mononitrate compared with sclerotherapy for the prevention of variceal rebleeding. N Engl J Med. 1996;334:1624-1629.
24. Villanueva C, Minana J, Ortiz J, et al. Endoscopic ligation compared with combined treatment with nadolol and isosorbide mononitrate to prevent recurrent variceal bleeding. N Engl J Med. 2001;345:647-655.
25. Patch D, Sabin CA, Goulis J, et al. A randomized, controlled trial of medical therapy versus endoscopic ligation for the prevention of variceal rebleeding in patients with cirrhosis. Gastroenterology. 2002;123:1013-1019.
26. Escorsell A, Banares R, Garcia-Pagan JC, et al. TIPS versus drug therapy in preventing variceal rebleeding in advanced cirrhosis: a randomized controlled trial. Hepatology. 2002;35:385-392.
27. Merkel C, Bolognesi M, Sacerdoti D, et al. The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology. 2000;32:930-934.
28. Vorobioff J, Groszmann RJ, Picabea E, et al. Prognostic value of hepatic venous pressure gradient measurements in alcoholic cirrhosis: a 10-year prospective study. Gastroenterology. 1996;111:701-709.
29. Groszmann RJ, Garcia-Tsao G. Endoscopic variceal banding vs. pharmacological therapy for the prevention of recurrent variceal hemorrhage: what makes the difference? Gastroenterology. 2002;123:1388-1391.
30. McCormick PA, Patch D, Greenslade L, Chin J, McIntyre N, Burroughs AK. Clinical vs haemodynamic response to drugs in portal hypertension. J Hepatol. 1998;28:1015-1019.
31. Valla D, Jiron MI, Poynard T, Braillon A, Lebrec D. Failure of haemodynamic measurements to predict recurrent gastrointestinal bleeding in cirrhotic patients receiving propranolol. J Hepatol. 1987;5:144-148.
32. Kahn D, Jones B, Bornman PC, Terblanche J. Incidence and management of complications after injection sclerotherapy: a ten-year prospective evaluation. Surgery. 1989;105(2 Pt 1):160-165.
33. Waked I, Korula J. Analysis of long-term endoscopic surveillance during follow-up after variceal sclerotherapy from a 13-year experience. Am J Med. 1997;102:192-199.
34. Young MF, Sanowski RA, Rasche R. Comparison and characterization of ulcerations induced by endoscopic ligation of esophageal varices versus endoscopic sclerotherapy. Gastrointest Endosc. 1993;39:119-122.
35. Goulis J, Burroughs AK. Portal Hypertensive bleeding: prevention and treatment. In: McDonald J, Burroughs A, Feagan B, ed. Evidence Based Gastroenterology and Hepatology. London, UK: BMJ Books; 1999:389-426.
36. Dagher L, Patch D, Burroughs A. Drug treatment for bleeding oesophageal varices. Baillieres Best Pract Res Clin Gastroenterol. 2000;14:365-390.
37. Jensen LS, Krarup N. Propranolol in prevention of rebleeding from oesophageal varices during the course of endoscopic sclerotherapy. Scand J Gastroenterol. 1989;24:339-345.
38. Benedeto-Stojanov D, Tasic T, Bjelakovic G, Nagorni A. Prevention of recurrent upper gastrointestinal bleeding with propranolol in patients with cirrhosis undergoing endoscopic sclerotherapy. J Hepatol. 2000;32[suppl 2]:72A.
39. Primignani M, Andreoni B, Carpinelli L, et al. Sclerotherapy plus octreotide versus sclerotherapy alone in the prevention of early rebleeding from esophageal varices: a randomized, double-blind, placebo-controlled, multicenter trial. New Italian Endoscopic Club. Hepatology. 1995;21:1322-1327.
40. D'amico G, Politi F, Morabito A, et al. Octreotide compared with placebo in a treatment strategy for early rebleeding in cirrhosis. A double blind, randomized pragmatic trial. Hepatology. 1998;28:1206-1214.
41. Jenkins SA, Baxter JN, Critchley M, et al. Randomised trial of octreotide for long term management of cirrhosis after variceal haemorrhage. BMJ. 1997;315:1338-1341.
42. Agrawal SR, Gupta R, Murthy NS, Sarin S. Comparable efficacy of propranolol plus isosorbide mononitrate and endoscopic variceal ligation in prevention of variceal rebleed. J Hepatol. 2002;36[suppl]:631A.
43. Lo GH, Chen WC, Chen MH, et al. Banding ligation versus nadolol and isosorbide mononitrate for the prevention of esophageal variceal rebleeding. Gastroenterology. 2002;123:728-734.
44. Lo GH, Lai KH, Cheng JS, et al. Endoscopic variceal ligation plus nadolol and sucralfate compared with ligation alone for the prevention of variceal rebleeding: a prospective, randomized trial. Hepatology. 2000;32:461-465.
45. Leung VK, Sung JJ, Ahuja AT, et al. Large paraesophageal varices on endosonography predict recurrence of esophageal varices and rebleeding. Gastroenterology. 1997;112:1811-1816.
46. Gostout CJ. Endoscopic esophageal variceal band ligation: how intensively should we ligate? Am J Gastroenterol. 1998;93:135-137.
47. Stiegmann GV, Goff JS, Michaletz-Onody PA, et al. Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices. N Engl J Med. 1992;326:1527-1532.
48. Baroncini D, Milandri GL, Borioni D, et al. A prospective randomized trial of sclerotherapy versus ligation in the elective treatment of bleeding esophageal varices. Endoscopy. 1997;29:235-240.
49. Takase Y, Shibuya S, Chikamori F, Orii K, Iwasaki Y. Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices. Hepatology. 1990;11:348-352.
50. Singh P, Pooran N, Indaram A, Bank S. Combined ligation and sclerotherapy versus ligation alone for secondary prophylaxis of esophageal variceal bleeding: a meta-analysis. Am J Gastroenterol. 2002;97:623-629.
51. Barton RE, Rosch J, Saxon RR, et al. TIPS: short and long-term results: a survey of 1750 patients. Semin Interv Radiol. 1995;12:364.
52. Papatheodoridis GV, Goulis J, Leandro G, Patch D, Burroughs AK. Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: A meta-analysis. Hepatology. 1999;30:612-622.
53. Burroughs AK, Vangeli M. Transjugular intrahepatic portosystemic shunt versus endoscopic therapy: randomized trials for secondary prophylaxis of variceal bleeding: an updated meta-analysis. Scand J Gastroenterol. 2002;37:249-252.
54. Sauer P, Hansmann J, Richter GM, Stremmel W, Stiehl A. Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial. Endoscopy. 2002;34:690-697.
55. Ferguson JM, Jalan R, Redhead DN, Hayes PC, Allan PL. The role of duplex and colour Doppler ultrasound in the follow-up evaluation of transjugular intrahepatic portosystemic stent shunt (TIPSS). Br J Radiol. 1995;68:587-589.
56. Henderson JM, Nagle A, Curtas S, Geisinger M, Barnes D. Surgical shunts and TIPS for variceal decompression in the 1990s. Surgery. 2000;128:540-547.
57. Orozco H, Mercado MA. The evolution of portal hypertension surgery: lessons from 1000 operations and 50 Years' experience. Arch Surg. 2000;135:1389-1393.
58. Mercado MA, Orozco H, Ramirez-Cisneros FJ, Hinojosa CA, Plata JJ, Alvarez-Tostado J. Diminished morbidity and mortality in portal hypertension surgery: relocation in the therapeutic armamentarium. J Gastrointest Surg. 2001;5:499-502.
59. Hillebrand DJ, Kojouri K, Cao S, Runyon BA, Ojogho O, Concepcion W. Small-diameter portacaval H-graft shunt: a paradigm shift back to surgical shunting in the management of variceal bleeding in patients with preserved liver function. Liver Transpl. 2000;6:459-465.
60. Borgonovo G, Costantini M, Grange D, Vons C, Smadja C, Franco D. Comparison of a modified Sugiura procedure with portal systemic shunt for prevention of recurrent variceal bleeding in cirrhosis. Surgery. 1996;119:214-221.
61. Orozco H, Mercado MA, Chan C, Guillen-Navarro E, Lopez-Martinez LM. A comparative study of the elective treatment of variceal hemorrhage with beta-blockers, transendoscopic sclerotherapy, and surgery: a prospective, controlled, and randomized trial during 10 years. Ann Surg. 2000;232:216-219.
62. Shah SR. The difficulties in carrying out this study comparing three established modalities of preventing recurrent variceal hemorrhage in patients with portal hypertension. Ann Surg. 2001;234:263-265.
63. Spina GP, Henderson JM, Rikkers LF, et al. Distal spleno-renal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. A meta-analysis of 4 randomized clinical trials. J Hepatol. 1992;16:338-345.
64. Rikkers LF, Jin G, Burnett DA, Buchi KN, Cormier RA. Shunt surgery versus endoscopic sclerotherapy for variceal hemorrhage: late results of a randomized trial. Am J Surg. 1993;165:27-32.
65. Rikkers LF, Burnett DA, Volentine GD, Buchi KN, Cormier RA. Shunt surgery versus endoscopic sclerotherapy for long-term treatment of variceal bleeding. Early results of a randomized trial. Ann Surg. 1987;206:261-271.
66. Rosemurgy AS, Goode SE, Zwiebel BR, Black TJ, Brady PG. A prospective trial of transjugular intrahepatic portasystemic stent shunts versus small-diameter prosthetic H-graft portacaval shunts in the treatment of bleeding varices. Ann Surg. 1996;224:378-384.
67. Rosemurgy AS, Serafini FM, Zweibel BR, et al. Transjugular intrahepatic portosystemic shunt vs. small-diameter prosthetic H-graft portacaval shunt: extended follow-up of an expanded randomized prospective trial. J Gastrointest Surg. 2000;4:589-597.
68. Rosemurgy AS, Bloomston M, Zervos EE, et al. Transjugular intrahepatic portosystemic shunt versus H-graft portacaval shunt in the management of bleeding varices: a cost-benefit analysis. Surgery. 1997;122:794-799.
69. Khaitiyar JS, Luthra SK, Prasad N, Ratnakar N, Daruwala DK. Transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt - a comparative study. Hepatogastroenterology. 2000;47:492-497.
70. Helton WS, Maves R, Wicks K, Johansen K. Transjugular intrahepatic portasystemic shunt vs surgical shunt in good-risk cirrhotic patients: a case-control comparison. Arch Surg. 2001;136:17-20.
71. Zacks SL, Sandler RS, Biddle AK, Mauro MA, Brown RS Jr. Decision-analysis of transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt for portal hypertension. Hepatology. 1999;29:1399-1405.
72. Ringe B, Lang H, Tusch G, Pichlmayr R. Role of liver transplantation in management of esophageal variceal hemorrhage. World J Surg. 1994;18:233-239.
73. Rikkers LF, Jin G, Langnas AN, Shaw BW Jr. Shunt surgery during the era of liver transplantation. Ann Surg. 1997;226:51-57.
74. Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology. 1992;16:1343-1349.
75. Kim T, Shijo H, Kokawa H, et al. Risk factors for hemorrhage from gastric fundal varices. Hepatology. 1997;25:307-312.
76. See A, Florent C, Lamy P, Levy VG, Bouvry M. [Cerebrovascular accidents after endoscopic obturation of esophageal varices with isobutyl-2-cyanoacrylate in 2 patients]. Gastroenterol Clin Biol. 1986;10:604-607.
77. Verger P, Blais J, Gruau M, Haffaf Y. [Retrogastric abscess secondary to gastric varices obturation with cyanoacrylate]. Gastroenterol Clin Biol. 1998;22:248-249.
78. Cheng PN, Sheu BS, Chen CY, Chang TT, Lin XZ. Splenic infarction after histoacryl injection for bleeding gastric varices. Gastrointest Endosc. 1998;48:426-427.
79. Miyazaki S, Yoshida T, Harada T, Shigemitsu T, Takeo Y, Okita K. Injection sclerotherapy for gastric varices using N-butyl-2-cyanoacrylate and ethanolamine oleate. Hepatogastroenterology. 1998;45:1155-1158.
80. Kulling D, Woo S, Demcheva MV, Hawes RH, Vournakis JN. Poly-N-acetyl glucosamine: will it replace cyanoacrylate for treatment of gastric varices? A pilot study in a rabbit model. Endoscopy. 1998;30:S41-S42.
81. Kulling D, Vournakis JN, Woo S, et al. Endoscopic injection of bleeding esophageal varices with a poly-N-acetyl glucosamine gel formulation in the canine portal hypertension model. Gastrointest Endosc. 1999;49:764-771.
82. Binmoeller KF. Glue for gastric varices: some sticky issues. Gastrointest Endosc. 2000;52:298-301.
83. Mastumoto A, Matsumoto H, Inokuchi H. Isolated gastric fundal varices: a challenging issue. Am J Gastroenterol. 2002;97:2930-2931.
84. Matsumoto A, Hamamoto N, Nomura T, et al. Balloon-occluded retrograde transvenous obliteration of high risk gastric fundal varices. Am J Gastroenterol. 1999;94:643-649.
85. Chau TN, Patch D, Chan YW, Nagral A, Dick R, Burroughs AK. "Salvage" transjugular intrahepatic portosystemic shunts: gastric fundal compared with esophageal variceal bleeding. Gastroenterology. 1998;114:981-987.
86. Stanley AJ, Jalan R, Ireland HM, Redhead DN, Bouchier IA, Hayes PC. A comparison between gastric and oesophageal variceal haemorrhage treated with transjugular intrahepatic portosystemic stent shunt (TIPSS). Aliment Pharmacol Ther. 1997;11:171-176.
87. Cipolletta L, Bianco MA, Rotondano G, Marmo R, Meucci C, Piscopo R. Argon plasma coagulation prevents variceal recurrence after band ligation of esophageal varices: preliminary results of a prospective randomized trial. Gastrointest Endosc. 2002;56:467-471.
88. Norton ID, Wang L, Levine SA, et al. In vivo characterization of colonic thermal injury caused by argon plasma coagulation. Gastrointest Endosc. 2002;55:631-636.
89. Rockey D. The cellular pathogenesis of portal hypertension: stellate cell contractility, endothelin, and nitric oxide. Hepatology. 1997;25:2-5.
90. Shah V, Garcia-Cardena G, Sessa WC, Groszmann RJ. The hepatic circulation in health and disease: report of a single-topic symposium. Hepatology. 1998;27:279-288.
91. Sogni P, Moreau R, Gomola A, et al. Beneficial hemodynamic effects of bosentan, a mixed ET(A) and ET(B) receptor antagonist, in portal hypertensive rats. Hepatology. 1998;28:655-659.
92. Mittal MK, Gupta TK, Lee FY, Sieber CC, Groszmann RJ. Nitric oxide modulates hepatic vascular tone in normal rat liver. Am J Physiol. 1994;267(3 Pt 1):G416-G422.
93. Gupta TK, Toruner M, Chung MK, Groszmann RJ. Endothelial dysfunction and decreased production of nitric oxide in the intrahepatic microcirculation of cirrhotic rats. Hepatology. 1998;28:926-931.
94. Fevery J, Roskams T, Van de CM, et al. NO synthase in the liver: prospects of in vivo gene transfer. Digestion. 1998;59(Suppl 2):58-59.
95. Rassiat E, Moreau R, Barriere E, et al. Relationship between antiviral therapy responses and hepatic venous pressure gradient changes. J Hepatol. 2002;36:174-175.
96. Bataller R, Gines P, Nicolas JM, et al. Angiotensin II induces contraction and proliferation of human hepatic stellate cells. Gastroenterology. 2000;118:1149-1156.
97. Yoo KH, Thornhill BA, Wolstenholme JT, Chevalier RL. Tissue-specific regulation of growth factors and clusterin by angiotensin II. Am J Hypertens. 1998;11:715-722.
98. Jonsson JR, Clouston AD, Ando Y, et al. Angiotensin-converting enzyme inhibition attenuates the progression of rat hepatic fibrosis. Gastroenterology. 2001;121:148-155.
99. Cho JJ, Hocher B, Herbst H, et al. An oral endothelin-A receptor antagonist blocks collagen synthesis and deposition in advanced rat liver fibrosis. Gastroenterology. 2000;118:1169-1178.
100. Rockey DC, Chung JJ. Endothelin antagonism in experimental hepatic fibrosis. Implications for endothelin in the pathogenesis of wound healing. J Clin Invest. 1996;98:1381-1388.
101. Poo JL, Jimenez W, Maria MR, et al. Chronic blockade of endothelin receptors in cirrhotic rats: hepatic and hemodynamic effects. Gastroenterology. 1999;116:161-167.
102. Rockey DC. Vasoactive agents in intrahepatic portal hypertension and fibrogenesis: implications for therapy. Gastroenterology. 2000;118:1261-1265.
103. Caligiuri A, De Franco RM, Romanelli RG, et al. Antifibrogenic effects of canrenone, an antialdosteronic drug, on human hepatic stellate cells. Gastroenterology. 2003;124:504-520.
104. Pariente EA, Bataille C, Bercoff E, Lebrec D. Acute effects of captopril on systemic and renal hemodynamics and on renal function in cirrhotic patients with ascites. Gastroenterology. 1985;88:1255-1259.
105. Ibarra FR, Afione C, Garzon D, Barontini M, Santos JC, Arrizurieta E. Portal pressure, renal function and hormonal profile after acute and chronic captopril treatment in cirrhosis. Eur J Clin Pharmacol. 1992;43:477-482.
106. Gentilini P, Romanelli RG, La Villa G, et al. Effects of low-dose captopril on renal hemodynamics and function in patients with cirrhosis of the liver. Gastroenterology. 1993;104:588-594.
107. Atlas SA, Case DB, Yu ZY, Laragh JH. Hormonal and metabolic effects of angiotensin converting enzyme inhibitors. Possible differences between enalapril and captopril. Am J Med. 1984;77:13-17.
108. Chiang HT, Cheng JS, Lin M, Tseng WS, Chang JM, Lai KH. Haemodynamic effects of enalaprilat on portal hypertension in patients with HBsAg-positive cirrhosis. J Gastroenterol Hepatol. 1995;10:256-260.
109. Svoboda P, Ochmann J, Kantorova I. Effect of enalapril treatment and sclerotherapy of esophageal varices on hepatic hemodynamics in portal hypertension. Hepatogastroenterology. 1992;39:549-552.
110. Nasr AA, el Hak NG, Settein ME, Khafagy MA, Tadros MT. Effects of angiotensin-converting enzyme inhibitors and sclerotherapy on portal hemodynamics in patients with portal hypertension. Hepatogastroenterology. 2000;47:795-806.
111. Arroyo V, Bosch J, Mauri M, Ribera F, Navarro-Lopez F, Rodes J. Effect of angiotensin-II blockade on systemic and hepatic haemodynamics and on the renin-angiotensin-aldosterone system in cirrhosis with ascites. Eur J Clin Invest. 1981;11:221-229.
112. Schneider AW, Kalk JF, Klein CP. Effect of losartan, an angiotensin II receptor antagonist, on portal pressure in cirrhosis. Hepatology. 1999;29:334-339.
113. Gonzalez-Abraldes J, Albillos A, et al. Randomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis. Gastroenterology. 2001;121:382-388.
114. Klein CG, Kalk JF, May B, Klein CP. Efficiency of irbesartan, an angiotensin II receptor antagonist on portal pressure and hepatic resistance in cirrhosis of the liver. Hepatology. 2000;32:532A.
115. Schepke M, Werner E, Biecker E, et al. Hemodynamic effects of the angiotensin II receptor antagonist irbesartan in patients with cirrhosis and portal hypertension. Gastroenterology. 2001;121:389-395.
116. Debernardi-Venon W, Barletti C, Alessandria C, et al. Efficacy of irbesartan, a receptor selective antagonist of angiotensin II, in reducing portal hypertension. Dig Dis Sci. 2002;47:401-404.
117. Vlachogiannakos J, Tang AK, Patch D, Burroughs AK. Angiotensin converting enzyme inhibitors and angiotensin II antagonists as therapy in chronic liver disease. Gut. 2001;49:303-308.
118. Mills PR, Rae AP, Farah DA, Russell RI, Lorimer AR, Carter DC. Comparison of three adrenoreceptor blocking agents in patients with cirrhosis and portal hypertension. Gut. 1984;25:73-78.
119. Albillos A, Lledo JL, Rossi I, et al. Continuous prazosin administration in cirrhotic patients: effects on portal hemodynamics and on liver and renal function. Gastroenterology. 1995;109:1257-1265.
120. Albillos A, Garcia-Pagan JC, Iborra J, et al. Propranolol plus prazosin compared with propranolol plus isosorbide-5-mononitrate in the treatment of portal hypertension. Gastroenterology. 1998;115:116-123.
121. Frishman WH. Carvedilol. N Engl J Med. 1998;339:1759-1765.
122. Forrest EH, Bouchier IA, Hayes PC. Acute haemodynamic changes after oral carvedilol, a vasodilating beta-blocker, in patients with cirrhosis. J Hepatol. 1996;25:909-915.
123. Banares R, Moitinho E, Piqueras B, et al. Carvedilol, a new nonselective beta-blocker with intrinsic anti- Alpha1-adrenergic activity, has a greater portal hypotensive effect than propranolol in patients with cirrhosis. Hepatology. 1999;30:79-83.
124. Banares R, Moitinho E, Matilla A, et al. Randomized comparison of long-term carvedilol and propranolol administration in the treatment of portal hypertension in cirrhosis. Hepatology. 2002;36:1367-1373.
125. Stanley AJ, Therapondos G, Helmy A, Hayes PC. Acute and chronic haemodynamic and renal effects of carvedilol in patients with cirrhosis. J Hepatol. 1999;30:479-484.
126. Tripathi D, Therapondos G, Lui HF, Stanley AJ, Hayes PC. Haemodynamic effects of acute and chronic administration of low-dose carvedilol, a vasodilating beta-blocker, in patients with cirrhosis and portal hypertension. Aliment Pharmacol Ther. 2002;16:373-380.
127. Albillos A, Banares R, Barrios C, et al. Oral administration of clonidine in patients with alcoholic cirrhosis. Hemodynamic and liver function effects. Gastroenterology. 1992;102:248-254.
128. Roulot D, Moreau R, Gaudin C, et al. Long-term sympathetic and hemodynamic responses to clonidine in patients with cirrhosis and ascites. Gastroenterology. 1992;102:1309-1318.
129. Tincani E, Cioni G, D'Alimonte P, et al. Effects of propranolol compared with clonidine on portal haemodynamics: a double-blind cross-over study using duplex-Doppler ultrasonography. Eur J Gastroenterol Hepatol. 1995;7:893-897.
130. Cereda JM, Roulot D, Braillon A, Moreau R, Koshy A, Lebrec D. Reduction of portal pressure by acute administration of furosemide in patients with alcoholic cirrhosis. J Hepatol. 1989;9:246-251.
131. Atkinsons M. The effects of diuretics on portal venous pressure. Lancet. 1959;2:819-823.
132. Okumura H, Aramaki T, Katsuta Y, et al. Reduction in hepatic venous pressure gradient as a consequence of volume contraction due to chronic administration of spironolactone in patients with cirrhosis and no ascites. Am J Gastroenterol. 1991;86:46-52.
133. Garcia-Pagan JC, Salmeron JM, Feu F, et al. Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis. Hepatology. 1994;19:1095-1099.
134. Nevens F, Lijnen P, VanBilloen H, Fevery J. The effect of long-term treatment with spironolactone on variceal pressure in patients with portal hypertension without ascites. Hepatology. 1996;23:1047-1052.
135. Sugano S, Suzuki T, Nishio M, Makino H, Okajima T. Chronic splanchnic hemodynamic effects of low-dose transdermal nitroglycerin versus low-dose transdermal nitroglycerin plus spironolactone in patients with cirrhosis. Dig Dis Sci. 1997;42:529-535.
136. Hadengue A, Lee SS, Moreau R, Braillon A, Lebrec D. Beneficial hemodynamic effects of ketanserin in patients with cirrhosis: possible role of serotonergic mechanisms in portal hypertension. Hepatology. 1987;7:644-647.
137. Vorobioff J, Garcia-Tsao G, Groszmann R, et al. Long-term hemodynamic effects of ketanserin, a 5-hydroxytryptamine blocker, in portal hypertensive patients. Hepatology. 1989;9:88-91.
138. Ladero Quesada JM, Diez OS, Gallego Beuter JJ, Hernandez LA, Herraiz Serrano ML, Diaz-Rubio GM. [Addition of ritanserin to the treatment with propranolol in cirrhotic patients: effects on portal pressure]. An Med Interna. 1994;11:162-166.
139. Hadengue A, Moreau R, Cerini R, Koshy A, Lee SS, Lebrec D. Combination of ketanserin and verapamil or propranolol in patients with alcoholic cirrhosis: search for an additive effect. Hepatology. 1989;9:83-87.
140. Goulis J, Patch D, Burroughs AK. Bacterial infection in the pathogenesis of variceal bleeding. Lancet. 1999;353:139-142.
141. Guarner C, Soriano G, Tomas A, et al. Increased serum nitrite and nitrate levels in patients with cirrhosis: relationship to endotoxemia. Hepatology. 1993;18:1139-1143.
142. Ziegler EJ, McCutchan JA, Fierer J, et al. Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli. N Engl J Med. 1982;307:1225-1230.
143. Rockey DC, Weisiger RA. Endothelin induced contractility of stellate cells from normal and cirrhotic rat liver: implications for regulation of portal pressure and resistance. Hepatology. 1996; 24:233-240.
144. Yamamoto S, Burman HP, O'Donnell CP, Cahill PA, Robotham JL. Endothelin causes portal and pulmonary hypertension in porcine endotoxemic shock. Am J Physiol. 1997;272(3 Pt 2):H1239-H1249.
145. Radomski MW, Palmer RM, Moncada S. Endogenous nitric oxide inhibits human platelet adhesion to vascular endothelium. Lancet. 1987;2:1057-1058.
146. Mastai R, Grande L, Bosch J, et al. Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension. Hepatology. 1986;6:1244-1247.
147. Kleber G, Sauerbruch T, Fischer G, Geigenberger G, Paumgartner G. Reduction of transmural oesophageal variceal pressure by metoclopramide. J Hepatol. 1991;12:362-366.
148. Hosking SW, Doss W, el Zeiny H, Robinson P, Barsoum MS, Johnson AG. Pharmacological constriction of the lower oesophageal sphincter: a simple method of arresting variceal haemorrhage. Gut. 1988;29:1098-1102.
149. Vinel JP, Monnin JL, Combis JM, Cales P, Desmorat H, Pascal JP. Hemodynamic evaluation of molsidomine: a vasodilator with antianginal roperties in patients with alcoholic cirrhosis. Hepatology. 1990;11:239-242.
150. Garcia-Pagan JC, Escorsell A, Feu F, et al. Propranolol plus molsidomine vs propranolol alone in the treatment of portal hypertension in patients with cirrhosis. J Hepatol. 1996;24:430-435.
151. Combis JM, Vinel JP, Badia P, et al. Haemodynamic effects of molsidomine and propranolol in patients with cirrhosis. Br J Clin Pharmacol. 1996;41:409-413.
152. Hori N, Okanoue T, Sawa Y, Mori T, Kashima K. Haemodynamic effects of combined treatment with molsidomine and propranolol on portal hypertension in conscious and unrestrained cirrhotic rats. J Gastroenterol. Hepatol 1996;11:985-992.
153. Ozturk H, Yagmur Y, Buyukbayram H, Dokucu AI, Gurel A. Effects of the nitric oxide donor molsidomine on the early stages of liver damage in rats with bile duct ligation: a biochemical and immunohistochemical approach. Eur Surg Res. 2002;34:285-290.
154. Abraczinskas DR, Ookubo R, Grace ND, et al. Propranolol for the prevention of first esophageal variceal hemorrhage: a lifetime commitment? Hepatology. 2001;34:1096-1102.