Self-expandable metal stents in the treatment of acute esophageal variceal bleeding
Acute variceal bleeding (AVB) is a life-threatening complication in patients with cirrhosis. Hemostatic therapy of AVB includes early administration of vasoactive drugs that should be combined with endoscopic therapy, preferably banding ligation. However, failure to control bleeding or early rebleed...
| Autores: | ; |
|---|---|
| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2011 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/57283 |
| Acceso en línea: | https://hdl.handle.net/2445/57283 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Varices esofàgiques Cirrosi hepàtica Terapèutica Esophageal varices Hepatic cirrhosis Therapeutics |
| _version_ | 1878737895770030080 |
|---|---|
| author | Escorsell i Mañosa, M. Àngels |
| author2 | Bosch i Genover, Jaume |
| author2_role | author |
| author_browse | Bosch i Genover, Jaume Escorsell i Mañosa, M. Àngels |
| author_facet | Escorsell i Mañosa, M. Àngels Bosch i Genover, Jaume |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Acute variceal bleeding (AVB) is a life-threatening complication in patients with cirrhosis. Hemostatic therapy of AVB includes early administration of vasoactive drugs that should be combined with endoscopic therapy, preferably banding ligation. However, failure to control bleeding or early rebleed within 5 days still occurs in 15-20% of patients with AVB. In these cases, a second endoscopic therapy may be attempted (mild bleeding in a hemodynamically stable patient) or we can use a balloon tamponade as a bridge to definitive derivative treatment (i.e., a transjugular intrahepatic portosystemic shunt). Esophageal balloon tamponade provides initial control in up to 80% of AVB, but it carries a high risk of major complications, especially in cases of long duration of tamponade (>24 h) and when tubes are inserted by inexperienced staff. Preliminary reports suggest that self-expandable covered esophageal metallic stents effectively control refractory AVB (i.e., ongoing bleeding despite pharmacological and endoscopic therapy or massive bleeding precluding endoscopic therapy) with a low incidence of complications. Thus, covered self-expanding metal stents may represent an alternative to the Sengstaken-Blakemore balloon for the temporary control of bleeding in treatment failures. Further studies are required to determine the role of this new device in AVB. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_a690e4fe4fd5b2a9ff4abb6bc2bc58bc |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/57283 |
| publishDate | 2011 |
| publishDateSort | 2011 |
| publisher | Hindawi Publishing Corporation |
| publisherStr | Hindawi Publishing Corporation |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding Escorsell i Mañosa, M. Àngels Bosch i Genover, Jaume Varices esofàgiques Cirrosi hepàtica Terapèutica Esophageal varices Hepatic cirrhosis Therapeutics Acute variceal bleeding (AVB) is a life-threatening complication in patients with cirrhosis. Hemostatic therapy of AVB includes early administration of vasoactive drugs that should be combined with endoscopic therapy, preferably banding ligation. However, failure to control bleeding or early rebleed within 5 days still occurs in 15-20% of patients with AVB. In these cases, a second endoscopic therapy may be attempted (mild bleeding in a hemodynamically stable patient) or we can use a balloon tamponade as a bridge to definitive derivative treatment (i.e., a transjugular intrahepatic portosystemic shunt). Esophageal balloon tamponade provides initial control in up to 80% of AVB, but it carries a high risk of major complications, especially in cases of long duration of tamponade (>24 h) and when tubes are inserted by inexperienced staff. Preliminary reports suggest that self-expandable covered esophageal metallic stents effectively control refractory AVB (i.e., ongoing bleeding despite pharmacological and endoscopic therapy or massive bleeding precluding endoscopic therapy) with a low incidence of complications. Thus, covered self-expanding metal stents may represent an alternative to the Sengstaken-Blakemore balloon for the temporary control of bleeding in treatment failures. Further studies are required to determine the role of this new device in AVB. Hindawi Publishing Corporation https://hdl.handle.net/2445/57283 |
| spellingShingle | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding Escorsell i Mañosa, M. Àngels Varices esofàgiques Cirrosi hepàtica Terapèutica Esophageal varices Hepatic cirrhosis Therapeutics |
| status_str | publishedVersion |
| title | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| title_full | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| title_fullStr | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| title_full_unstemmed | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| title_short | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| title_sort | Self-expandable metal stents in the treatment of acute esophageal variceal bleeding |
| topic | Varices esofàgiques Cirrosi hepàtica Terapèutica Esophageal varices Hepatic cirrhosis Therapeutics |
| topic_facet | Varices esofàgiques Cirrosi hepàtica Terapèutica Esophageal varices Hepatic cirrhosis Therapeutics |
| url | https://hdl.handle.net/2445/57283 |