How to Control the Blood Flow of Inferior Phrenic Vein in the Case of Solitary Gastric Varices

Abstract

Gastric varices are frequently associated with inferior phrenic vein as an accessory shunt vessel (ASV) in addition to main shunt. How to control the blood flow of ASV is a matter of importance for transvenous obliteration therapy. Cases of successfully eradicated solitary gastric varices by controlling the blood flow of ASV using selfretaining catheter method (transvenous obliteration of porto-systemic shunt, TOPS) or coil embolization method are presented.
In order to control the blood flow of ASV, ethanolamine oleate iopamidol (EO) was administrated through selfretaining catheter depend on varicearography findings and could be infused every day as occasion demands.
We also performed coil embolization to stop the blood flow of ASV. Coil embolization was examined before ordinary transvenous obliteration therapy. Our results suggest that solitary gastric varices including usual difficult cases can be easily eradicated by these methods.