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10.1055/s-0034-1377980

http://scihub22266oqcxt.onion/10.1055/s-0034-1377980
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suck abstract from ncbi


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pmid26135101
      Endosc+Int+Open 2014 ; 2 (4 ): E244-51
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  • Self-Expanding Metal Stent (SEMS): an innovative rescue therapy for refractory acute variceal bleeding #MMPMID26135101
  • Changela K ; Ona MA ; Anand S ; Duddempudi S
  • Endosc Int Open 2014[Dec]; 2 (4 ): E244-51 PMID26135101 show ga
  • BACKGROUND: Acute variceal bleeding (AVB) is a life-threatening complication of liver cirrhosis or less commonly splenic vein thrombosis. Pharmacological and endoscopic interventions are cornerstones in the management of variceal bleeding but may fail in 10?-?15?% of patients. Rescue therapy with balloon tamponade (BT) or transjugular intrahepatic portosystemic shunt (TIPS) may be required to control refractory acute variceal bleeding effectively but with some limitations. The self-expanding metal stent (SEMS) is a covered, removable tool that can be deployed in the lower esophagus under endoscopic guidance as a rescue therapy to achieve hemostasis for refractory AVB. AIMS: To evaluate the technical feasibility, efficacy, and safety of SEMS as a rescue therapy for AVB. METHODS: In this review article, we have performed an extensive literature search summarizing case reports and case series describing SEMS as a rescue therapy for AVB. Indications, features, technique, deployment, success rate, limitations, and complications are discussed. RESULTS: At present, 103 cases have been described in the literature. Studies have reported 97.08?% technical success rates in deployment of SEMS. Most of the stents were intact for 4?-?14 days with no major complications reported. Stent extraction had a success rate of 100?%. Successful hemostasis was achieved in 96?% of cases with only 3.12?% found to have rebleeding after placement of SEMS. Stent migration, which was the most common complication, was observed in 21?% of patients. CONCLUSION: SEMS is a safe and effective alternative approach as a rescue therapy for refractory AVB.
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