ArticleBMJ open gastroenterology2023
Technical and clinical outcomes following EUS-guided thrombin injection and coil implantation for parastomal varices.
Article in BMJ open gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Management of parastomal variceal bleeding with endoscopic ultrasound-guided coiling and human thrombin/fibrinogen injection.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026Article
- Long cap-assisted visualization enabling bleeding point identification and clip hemostasis for stomal variceal bleeding.Endoscopy · 2026Article
- The evolving role of endoscopic ultrasound from diagnosis to therapy in hepatic vascular interventions.Frontiers in medicine · 2026Review
- Comment to: Ultrasound‑guided ilioinguinal‑iliohypogastric nerve block with local anesthesia and fentanyl analgesia versus local anesthesia and fentanyl analgesia prior to shouldice inguinal hernia repair in adults.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- EUS-Guided Vascular Interventions: Recent Advances.Journal of clinical medicine · 2024Review
- Ligating the varicose vein trunk for bleeding stomal varices in portal hypertension: a case report.Frontiers in medicine · 2024Article
- Endoscopic ultrasound in portal hypertension: navigating venous hemodynamics and treatment efficacy.Gastroenterology report · 2024Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsBleeding from parastomal varices causes significant morbidity and mortality. Treatment options are limited, particularly in high-risk patients with significant underlying liver disease and other comorbidities. The use of EUS-guided embolisation coils combined with thrombin injection in gastric varices has been shown to be safe and effective. Our institution has applied the same technique to the treatment of parastomal varices.
methodsA retrospective review was performed of 37 procedures on 24 patients to assess efficacy and safety of EUS-guided injection of thrombin, with or without embolisation coils for treatment of bleeding parastomal varices. All patients had been discussed in a multidisciplinary team meeting, and correction of portal hypertension was deemed to be contraindicated. Rebleeding was defined as stomal bleeding that required hospital admission or transfusion.
resultsAll patients had significant parastomal bleeding at the time of referral. 100% technical success rate was achieved. 70.8% of patients had no further significant bleeding in the follow-up period (median 26.2 months) following one procedure. 1-year rebleed-free survival was 80.8% following first procedure. 7 patients (29.1%) had repeat procedures. There was no significant difference in rebleed-free survival following repeat procedures. Higher age was associated with higher risk of rebleeding. No major procedure-related complications were identified.
conclusionsEUS-guided thrombin injection, with or without embolisation coils, is a safe and effective technique for the treatment of bleeding parastomal varices, particularly for patients for whom correction of portal venous hypertension is contraindicated.
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