The role of stenting in patients with variceal bleeding

F. N.U. Chesta, Zaheer H. Rizvi, Meher Oberoi, Navtej Buttar

Research output: Contribution to journalReview articlepeer-review

Abstract

Uncontrolled acute variceal hemorrhage due to failure of standard endoscopic therapy increases the risk of decompensation of liver disease and multiorgan failure leading to death. In this article, we aim to provide a structured and comprehensive review of the management of variceal bleeding by the use of self-expanding metal stent(s) (SEMS). The intricacies of the appropriate patient and stent selection, technicality of stent placement, deployment, and follow-up will be discussed. Furthermore, certain stent models with unique delivery system that eliminates the need of endoscopic or radiographic guidance will be reviewed. While patients with uncontrolled acute variceal hemorrhage are at a very high risk of adverse events, SEMS complications and the steps to prevent them will also discussed. As a vast majority of these cases represent advanced liver disease, liver transplant is ultimately required, thus, making SEMS an effective bridge to definitive therapy.

Original languageEnglish (US)
Pages (from-to)205-211
Number of pages7
JournalTechniques and Innovations in Gastrointestinal Endoscopy
Volume22
Issue number4
DOIs
StatePublished - Oct 2020

Keywords

  • Acute variceal hemorrhage
  • Endoscopic intervention in variceal bleeding
  • Portal hypertension
  • Self-expanding metal stent
  • Stent

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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