Ectopic varices: Anatomical classification, hemodynamic classification, and hemodynamic-based management

Techniques in Vascular and Interventional Radiology

Volumn 16, Issue 2, 2013, Pages 108-125

  Saad, Wael E A ^a   Lippert, Allison ^a   Saad, Nael E ^b   Caldwell, Stephen ^a  

^a UNIVERSITY OF VIRGINIA HEALTH SYSTEM   (United States)

^b WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Balloon occlusion; Duodenal varices; Ectopic varices; Obliteration; Sclerosant; Stomal varices; Trans TIPS; Transhepatic; Transjugular intrahepatic shunts; Transvenous obliteration

Indexed keywords

ANATOMICAL VARIATION; ARTICLE; ARTIFICIAL EMBOLISM; CLASSIFICATION; CLINICAL FEATURE; COMPUTER ASSISTED TOMOGRAPHY; DECOMPRESSION; DOPPLER FLOWMETRY; DUODENUM DISEASE; ECTOPIC VARICES; ESOPHAGUS VARICES BLEEDING; GASTROINTESTINAL ENDOSCOPY; GASTROINTESTINAL SURGERY; HEMODYNAMIC PARAMETERS; INCIDENCE; MESOCAVAL SHUNT; MORTALITY; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOLOGY; PORTAL VEIN THROMBOSIS; PORTOSYSTEMIC ANASTOMOSIS; RECANALIZATION; RISK ASSESSMENT; SPLANCHNIC BLOOD FLOW; SPLEEN ARTERY; STOMACH VARICES BLEEDING; SUSCEPTIBILITY WEIGHTED IMAGING; VARICOSIS;

EID: 84880018696     PISSN: 10892516     EISSN: 15579808     Source Type: Journal    
DOI: 10.1053/j.tvir.2013.02.004     Document Type: Article

References (47)

1. Tanaka O., Ohno K., Ohno T., et al. Should balloon-occluded retrograde transvenous obliteration be the first-line interventional radiologic treatment for bleeding duodenal varices? A case report and review of the literature. Acta Radiol 2008, 49:32-36.
2. Norton I.D., Andrews J.C., Kamath P.S. Management of ectopic varices. Hepatology 1998, 28:1154-1158.
3. Hashimoto N., Akhoshi T., Yoshida D., et al. The efficacy of balloon-occluded retrograde transvenous obliteration on small intestinal variceal bleeding. Surgery 2010, 148:145-150.
4. Kocher N., Tripathy D., McAvoy N.C., et al. Bleeding ectopic varices in cirrhosis: The role of transjugular intra-hepatic portosystemic stent shunts. Aliment Pharmaco Ther 2008, 28:294-303.
5. Onozato Y., Kakizaki S., Lizuka H., et al. Ectopic varices rupture in the gastroduodenal anastomosis successfully treated with N-butyl-2-cyanoacrylate injection. Acta Med 2007, 61:361-365.
6. Flemming R.J., Seaman W.B. Roentgenologic demonstration of unusual extra-esophageal varices. Am J Roentegenol 1968, 103:281-290.
7. Amin R., Alexis R., Korzis J. Fatal ruptured duodenal varix: A case report and review of literature. Am J Gastroenterol 1985, 14:105-119.
8. Kanagawa H., Mima S., Kouyama H., et al. Treatment of gastric fundal varices by balloon-occluded retrograde transvenous obliteration. J Gastroenterol Hepatol 1996, 11:51-58.
9. Shimizu T., Okabayashi Y., Andoh Y., et al. The duodenal varices: Report of a case a review of 70 Japanese cases. Mie Med J 1992, 42:215-221.
10. Hashizumi M., Tanoue K., Ohta M., et al. Vascular anatomy of duodenal varices: Angiographic and histopathological assessment. Am J Gastroenterol 1993, 88:1942-1945.
11. Itzchack Y., Glickman M.G. Varices in extrahepatic portal obstruction. Radiology 1977, 124:619-624.
12. Wang C.S., Jeng L.B., Chen M.F. Duodenal variceal bleeding successfully treated by mesocaval shunt after failure of sclerotherapy. Hepatogastroenterol 1995, 42:59-61.
13. Kouqeer F., Morrow C., Jordan P. Duodenal varices as a cause of massive upper gastrointestinal bleeding. Surgery 1987, 102:548-552.
14. Takamura K., Miyake H., Mori H., et al. Balloon occluded retrograde transvenous obliteration and percutaneous transhepatic obliteration for ruptured duodenal varices after operation for rectal cancer with multiple liver metastasis: A report of a case. J Med Invest 2005, 52:212-217.
15. Buhler L., Tamigneaux I., Giostra E., et al. Ectopic varices: A rare cause of digestive hemorrhage. Schweiz Med Wochenschr Suppl 1996, 79:70S-72S.
16. Cutler C.S., Rex D.K., Lehman G.A. Enteroscopic identification of ectopic small bowel varices. Gastrointest Endosc 1995, 41:605-608.
17. Miller L.S., Kim J.K., Dai Q., et al. Mechanics and hemodynamics of esophageal varices during peristaltic contraction. Am J Physiol Gastrointest Liver Physiol 2004, 287:G830-G835.
18. Arakawa M., Masuzaki T., Okuda K. Pathomorphology of esophageal and gastric varices. Semin Liver Dis 2002, 22:73-82.
19. Akazawa Y., Murata I., Yamao T., et al. Successful management of bleeding duodenal varices by endoscopic variceal ligation and balloon-occluded retrograde transvenous obliteration. Gastrointestinal Endoscopy 2003, 58:794-797.
20. Tominaga K., Montani A., Kuga T., et al. Combined balloon-occluded embolization for treatment of concurrent duodenal, gastric and esophageal varices: A case report. Gastrointestinal Endoscopy 2001, 53:665-668.
21. Itzcham Y., Glickman M.G. Duodenal varices in extrahepatic portal obstruction. Radiology 1977, 124:619-624.
22. Zamora C.A., Sugimoto K., Tsurusaki M., et al. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis. Eur Radiol 2006, 16:73-79.
23. Hotta M., Yoshida H., Mamada Y., et al. Successful management of duodenal varices by balloon-occluded retrograde transvenous obliteration. J Nippon Med Sch 2008, 75:36-40.
24. Vangeli M., Patch D., Terrini N., et al. Bleeding ectopic varices: Treatment with transjugular intrahepatic porto-systemic shunts (TIPS) and embolization. J Hepatol 2004, 41:560-566.
25. Ota K., Shirai Z., Masuzaki T., et al. Endoscopic injection sclerotherapy with N-butyl-2-cyanoacrylate for ruptured duodenal varices. J Gastroenterol 1998, 33:550-555.
26. Sans M., Llach J., Bordas J.M., et al. Thrombin and ethanolamine injection therapy in arresting uncontrolled bleeding from duodenal varices. Endoscopy 1996, 28:403.
27. Barbish A.W., Ehrinpreis M.N. Successful endoscopic injection sclerotherapy of a bleeding duodenal varix. Am J Gastroentrol 1993, 88:90-92.
28. Sato H., Fujishiro H., Rumi M.A., et al. Successful endoscopic injection sclerotherapy for duodenal varices. J Gastroenetrol 2002, 37:143-144.
29. Almeida J.R., Trevisan L., Guerrazzi F., et al. Bleeding duodenal varices successfully treated with TIPS. Dig Dis Sci 2006, 51:1738-1741.
30. Yoshida Y., Imai Y., Nisjikawa M., et al. Successful endoscopic sclerotherapy with N-butyl-2-cyanoacrylate following the recurrence of bleeding soon after endoscopic ligation for ruptured duodenal varices. Am J Gastroenterol 1997, 92:1227-1228.
31. Illuminati G., Smail A., Azoulay D., et al. Association of transjugular intrahepatic portosystemic shunt with embolization in the treatment of bleeding duodenal varix refractory to sclerotherapy. Dig Surg 2000, 17:398-400.
32. Jonnalagadda S.S., Quison S., Smith O.J. Successful therapy of bleeding duodenal varices by TIPS after failure of sclerotherapy. Am J Gastroenterol 1998, 93:272-274.
33. Tsurusaki M., Sugimoto K., Matsumoto S., et al. Bleeding duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (BRTO) assisted by CT during arterial portography. Cardivasc Intervent Radiol 2006, 29:1148-1151.
34. Ono S., Irie T., Kuramochi M., et al. Successful treatment of mesenteric varices with balloon-occluded retrograde transvenous obliteration via an abdominal wall vein. J Vasc Interv Radiol 2007, 18:1033-1035.
35. Haruta I., Isobe Y., Ueno E., et al. Balloon-occluded retrograde transvenous obliteration (BRTO), a promising nonsurgical therapy for ectopic varices: A case report of successful treatment of duodenal varices by BRTO. Am J Gastroenetrol 1996, 91:2594-2597.
36. Ota K., Okazaki M., Higashihara H., et al. Combination of transileocolic vein obliteration and balloon-occluded retrograde transvenous obliteration is effective for ruptured duodenal varices. J Gastroenterol 1999, 34:694-699.
37. Ohta M., Yasumori K., Saku M. Successful treatment of bleeding duodenal varices by balloon-occluded retrograde transvenous obliteration: A transjugular venous approach. Surgery 1999, 126:581-583.
38. Somomura T., Horihata K., Yamahara K., et al. Ruptured duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration: Usefulness of microcatheters. Am J Roentgenol 2003, 181:725-727.
39. Soga K., Tomikashi K., Fukamoto K., et al. Successful endoscopic hemostasis for ruptured duodenal varices after balloon-occluded retrograde transvenous obliteration. Dig Endosc 2010, 22:329-333.
40. Kim M.J., Jang B.K., Chung W.J., et al. Duodenal variceal bleeding after balloon-occluded retrograde transvenous obliteration: Treatment with transjugular intrahepatic portosystemic shunt. World J Gastroenterol 2012, 18:2877-2880.
41. Minami S., Okada K., Matsuo M., et al. Treatment of bleeding stomal varices by balloon-occluded retrograde transvenous obliteration. J Gastroenterol 2007, 42:91-95.
42. Tripathi D., Helmy A., Macbeth K., et al. Ten years' follow up of 472 patients following transjugular intrahepatic portosystemic shunt insertion at a single center. Eur J Gastroenterol 2004, 16:9-18.
43. Shibata D., Brophy D.P., Gordon F.D., et al. Transjugular intrahepatic portosystemic shunt for treatment of bleeding ectopic varices with portal hypertension. Dis Colon Rectum 1999, 42:1581-1585.
44. Vidal V., Joly L., Perreault P., et al. Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients. Cardiovasc Intervent Radiol 2006, 29:216-219.
45. Saad W.E.A., Darcy M.D. Transjugular intrahepatic portosystemic shunt (TIPS) versus balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices. Semin Interv Radiol 2011, 28:339-349.
46. Saad W.E.A., Al-Ossaimi A.M., Caldwell S. Pre- and post-BRTO imaging & clinical evaluation: Indications, management protocols & follow-up. Tech Vasc Interv Radiol 2012, 15:165-202.
47. Saad WEA, Saad NE, Jun Koizumi. Stomal varices: Management with decompression TIPS and transvenous obliteration or sclerosis. Tech Vasc Interv Radiol, in this issue.