Absolute ethanol was evaluated as a vaso-obliterative agent in 15 patients with bleeding of gastroesophageal varices. Initial control of hemorrhaging was obtained in 13 (87%). Two patients died from unrelated causes within 48 hours of the procedure. Variceal bleeding recurred in seven of the 11 remaining patients (64%) from one week to 13 months after embolization. Four patients did not rebleed; two of them died (4 weeks and 6 months after the procedure), and two are alive (14 and 16 months after the procedure). Significant disadvantages of ethanol for obliteration of gastroesophageal varices (marked prolongation of procedure time and lack of radio-opacity) probably contributed to the high incidence of portal vein thrombosis (3 patients [20%]).
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Portal hypertension: recommendations for diagnosis and treatment. Consensus document sponsored by the Spanish Association for the Study of the Liver (AEEH) and the Biomedical Research Network Centre for Liver and Digestive Diseases (CIBERehd).
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Portal hypertension is a hemodynamic abnormality that complicates the course of cirrhosis, as well as other diseases that affect the portal venous circulation. The development of portal hypertension compromises prognosis, especially when it rises above a certain threshold known as clinically significant portal hypertension (CSPH). In the consensus conference on Portal Hypertension promoted by the Spanish Association for the Study of the Liver and the Hepatic and Digestive diseases area of the Biomedical Research Networking Center (CIBERehd), different aspects of the diagnosis and treatment of portal hypertension caused by cirrhosis or other diseases were discussed.
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