Abstract
We evaluated Multi-Directional Endoscopic Varicealography during injection scleroth-erapy (IS) employing the digital angiographic (DA) system. From November 1996 to February 1997, IS utilizing the DA system vvas carried out on 8 patients with esophagealvarices. The injected sclerosant was 5% ethanolamine oleate with iopamidol(5% EOI).Endoscopic varicealography of the frontal and RAO views were obtained in all cases, butthe LAS and lateral views were obtained in only 3 cases. The cardiac venous plexus andthe cardiac branch of the left gastric vein were detected in 88% and 100% respectively, asesophageal blood supply routes. The paraesophageal and mediastinal veins were detectedin 50% and 25% respectively, as extraesophageal blood drainage routes. When weconfirmed the existence of these extraesophageal blood drainage routes, we immediatelystopped the injections. The total dose of the intravariceal injection of 5% EOI ranged from 7-33ml, which were within safety limits. In ail cases, the esophageal varices wereeradicated and the liver functions as well as the portal hemodynamics did not deteriorateafter the therapy. fur results show that Multi-directional Endoscopic Varicealographyduring IS employing the DA system can precisely control the dose of sclerosant, thereforethe effects of IS to the diver functions and the portal hemodynamics are minimized.
