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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 2/2018

01-02-2018 | Editorial

Esophageal Stents for Acute Variceal Bleeding: Expanding the Possibilities

Authors: Àngels Escorsell, Juan C. García-Pagán, Jaime Bosch

Published in: Digestive Diseases and Sciences | Issue 2/2018

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Excerpt

Esophageal acute variceal bleeding (AVB) is a severe complication of portal hypertension carrying an overall 6-week mortality of 10–30% according to the degree of liver dysfunction [1, 2]. Current treatment of AVB combines hemodynamic stabilization with careful intravascular volume replacement, antibiotic prophylaxis, vasoactive drugs such as terlipressin, somatostatin, or its analogues, and endoscopic treatment, preferably endoscopic band ligation (EBL) [3]. …
Literature
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Fortune BE, Garcia-Tsao G, Ciarleglio M, et al. Child–Turcotte–Pugh class is best at stratifying risk in variceal hemorrhage. Analysis of a US multicenter prospective study. J Clin Gastroenterol. 2017;51:446–453.CrossRef
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de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743–752.CrossRefPubMed
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Garcia-Tsao G, Sanyal AJ, Grace ND, Carey WD. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Am J Gastroenterol. 2007;102:2086–2102.CrossRefPubMed
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D’Amico M, Berzigotti A, Garcia-Pagán JC. Refractory acute variceal bleeding: what to do next? Clin Liver Dis. 2010;14:297–305.CrossRefPubMed
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de Franchis R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology, diagnosis and therapy in portal hypertension. J Hepatol. 2010;53:762–768.CrossRefPubMed
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Escorsell A, Pavel O, Cárdenas A, et al. Esophageal balloon tamponade vs esophageal stent in controlling acute refractory variceal bleeding: a multicenter RCT. Hepatology. 2016;63:1957–1967.CrossRefPubMed
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Cabrera L, Tandon P, Abraldes JG. An update on the management of acute esophageal variceal bleeding. Gastroenterol Hepatol. 2017;40:34–40.CrossRefPubMed
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Garcia-Pagán JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med. 2010;362:2370–2379.CrossRefPubMed
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Monescillo A, Martínez-Lagares F, Ruiz del Àrbol L, et al. Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding. Hepatology. 2004;40:793–801.CrossRefPubMed
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Garcia-Pagán JC, Di Pascoli M, Caca K, et al. Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study. J Hepatol. 2013;58:45–50.CrossRefPubMed
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Rudler M, Cluzel P, Corvec TL, et al. Early-TIPS placement prevents rebleeding in high-risk patients with variceal bleeding, without improving survival. Aliment Pharmacol Ther. 2014;40:1074–1080.CrossRefPubMed
Metadata
Title
Esophageal Stents for Acute Variceal Bleeding: Expanding the Possibilities
Authors
Àngels Escorsell
Juan C. García-Pagán
Jaime Bosch
Publication date
01-02-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 2/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4854-x

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Keynote webinar | Spotlight on medication adherence

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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