Transhepatic portal venography and selective obliteration of gastroesophageal varices using isobutyl 2-cyanoacrylate (Bucrylate)

Abstract

Five patients with Child's class C alcoholic cirrhosis and actively bleeding gastroesophageal varices underwent transhepatic portal venography and selective obliteration of varices with isobutyl 2-cyanoacrylate (Bucrylate). Temporary control of bleeding was obtained in four patients and complete control in one. This new technique is best utilized to stop active variceal hemorrhage in patients who are not candidates for portasystemic shunt surgery or to control bleeding while the patient's general medical condition is improved to decrease the risk of subsequent shunt surgery.