Vaz K, Efthymiou M, Vaughan R, Testro AG, Lew HB, Pu LZCT, Chandran S. Unpacking the challenge of gastric varices: A review on indication, timing and modality of therapy. World J Hepatol 2021; 13(8): 868-878 [PMID: 34552693 DOI: 10.4254/wjh.v13.i8.868]
Corresponding Author of This Article
Karl Vaz, MBBS, Doctor, Department of Gastroenterology and Hepatology, Austin Health, 145 Studley Rd, Heidelberg 3084, Victoria, Australia. karl.vaz@austin.org.au
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2021; 13(8): 868-878 Published online Aug 27, 2021. doi: 10.4254/wjh.v13.i8.868
Unpacking the challenge of gastric varices: A review on indication, timing and modality of therapy
Karl Vaz, Marios Efthymiou, Rhys Vaughan, Adam G Testro, Hin-Boon Lew, Leonardo Zorron Cheng Tao Pu, Sujievvan Chandran
Karl Vaz, Marios Efthymiou, Rhys Vaughan, Adam G Testro, Leonardo Zorron Cheng Tao Pu, Sujievvan Chandran, Department of Gastroenterology and Hepatology, Austin Health, Heidelberg 3084, Victoria, Australia
Marios Efthymiou, Rhys Vaughan, Sujievvan Chandran, University of Melbourne, Parkville 3052, Victoria, Australia
Hin-Boon Lew, Department of Radiology, Austin Health, Heidelberg 3084, Victoria, Australia
Author contributions: Vaz K, Efthymiou M, Vaughan R, Testro AG, Lew HB, Pu LZCT and Chandran S all contributed to the drafting and/or review of the manuscript.
Conflict-of-interest statement: The authors confirm there are no conflicts of interest to declare
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Karl Vaz, MBBS, Doctor, Department of Gastroenterology and Hepatology, Austin Health, 145 Studley Rd, Heidelberg 3084, Victoria, Australia. karl.vaz@austin.org.au
Received: February 24, 2021 Peer-review started: February 24, 2021 First decision: May 3, 2021 Revised: May 9, 2021 Accepted: July 29, 2021 Article in press: July 29, 2021 Published online: August 27, 2021 Processing time: 176 Days and 23.2 Hours
Abstract
Upper gastrointestinal bleeding from oesophageal or gastric varices is an important medical condition in patients with portal hypertension. Despite the emergence of a number of novel endoscopic and radiologic therapies for oesophagogastric varices, controversy exists regarding the indication, timing and modality of therapy. The aim of this review is to provide a concise and practical evidence-based overview of these issues.
Core Tip: Gastric varices are an uncommon source of bleeding in patients with portal hypertension. Although evidence supports acute bleeding treatment and secondary prophylaxis using interventional endoscopy or radiology, there is still lack of data to support primary prophylaxis for all patients. If treatment is required, both interventional endoscopy and radiological approaches should be considered. Interventional endoscopy using endoscopic ultrasound-guided combination coil and cyanoacrylate obliteration appears to be the optimal approach based on the current literature.
