A comprehensive review of transvenous obliteration techniques in the management of gastric varices

Diagn Interv Radiol. 2023 Jan 31;29(1):146-154. doi: 10.5152/dir.2022.21193. Epub 2023 Jan 11.


Bleeding gastric varices (GVs) is a life-threatening complication of portal hypertension, with higher morbidity and mortality rates compared with bleeding esophageal varices (EVs). The endovascular techniques for the management of GVs are mainly transjugular intrahepatic portosystemic shunt (TIPS) and transvenous obliteration of the GVs. Transvenous obliteration techniques can be an alternative or an adjunct to TIPS for treatment of GVs, depending on the clinical scenario, and are less invasive than TIPS. However, these procedures are associated with increased portal pressure and related complications, mainly worsening of the EVs. In this article, the different techniques of transvenous obliteration of GVs, their indications, contraindications, and outcomes are discussed.

Keywords: Cirrhosis; TIPS; gastric varices; transvenous obliteration; upper GI bleeding.

Publication types

  • Review

MeSH terms

  • Balloon Occlusion*
  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / diagnostic imaging
  • Esophageal and Gastric Varices* / surgery
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Hypertension, Portal* / complications
  • Hypertension, Portal* / surgery
  • Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects
  • Treatment Outcome