Esophageal and Gastric Varices (Esophageal Varices)

Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).

Also Known As:

Networked: 3633 relevant articles (312 outcomes, 408 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hemorrhage
2.	Varicose Veins (Varicose Vein)
3.	Fibrosis (Cirrhosis)
4.	Esophageal and Gastric Varices (Esophageal Varices)
5.	Portal Hypertension

Experts

1.	Sato, Takahiro: 12 articles (01/2012 - 01/2003)
2.	Orloff, Marshall J: 11 articles (06/2015 - 07/2009)
3.	Yamazaki, Katsu: 11 articles (01/2012 - 01/2003)
4.	Qi, Xingshun: 10 articles (12/2022 - 07/2015)
5.	Chayama, Kazuaki: 10 articles (01/2021 - 01/2008)
6.	Wang, Jian: 10 articles (01/2021 - 01/2016)
7.	Obara, Katsutoshi: 10 articles (11/2020 - 06/2002)
8.	Haynes, Kevin S: 10 articles (06/2015 - 07/2009)
9.	Hye, Robert J: 10 articles (06/2015 - 07/2009)
10.	Isenberg, Jon I: 10 articles (06/2015 - 07/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Esophageal and Gastric Varices:

1.	CyanoacrylatesIBA 01/01/2011 - "Cyanoacrylate injection (CI) might have a better outcome than VBL in the treatment of esophageal varices (EV) in these patients. " 01/01/2018 - "EUS-guided coil application with/without cyanoacrylate injection for the obliteration of gastric varices is effective for post-cyanoacrylate gastric variceal re-bleed." 06/01/2010 - "Endoscopic injection of gastric varices with cyanoacrylate is effective in prevention of rebleeding. " 09/01/2003 - "Cyanoacrylate treatment of gastric varices is safe, clinically effective, and cost effective." 07/01/2019 - "Endoscopic management of gastric varices with cyanoacrylate is a safe and effective treatment, with low recurrence and mortality rates."
2.	Propranolol (Inderal)FDA LinkGeneric 03/01/2015 - "Endoscopic ultrasonography assessment of para-esophageal varices predicts efficacy of propranolol in preventing recurrence of esophageal varices." 11/01/1990 - "In a double-blind randomized trial, the hemodynamic events following the administration of propranolol (n = 51) or a placebo (n = 51) were prospectively studied in cirrhotic patients with esophageal varices. " 08/01/2020 - "A second retrospective group of patients was made after reviewing medical records of 32 pediatric patients with PH that presented esophageal varices in the upper endoscopy and had received propranolol as primary prophylaxis. " 01/01/2009 - "One patient with newly developed gastric varices bled (propranolol group). " 01/01/2009 - "However, portal venous pressure was lower in group I. Early propranolol administration did not protect rats from developing esophageal varices, despite the fact that a significant decrease in portal pressure was detected."
3.	EnbucrilateIBA 12/01/2016 - "BRTO assisted endoscopic Histoacryl injection is effective and safe for patients with high-risk gastric varices and concurrent gastrorenal shunt." 04/01/2004 - "N-butyl cyanoacrylate injection has been shown to be effective and safe for the endoscopic treatment of gastric varices. " 05/01/2022 - "N-Butyl 2 Cyanoacrylate is safe and effective for treatment of gastric varices. " 05/01/2007 - "The aim of this study was to evaluate the long-term efficacy and safety of the endoscopic injection of Histoacryl for the treatment of gastric varices. " 09/01/2002 - "In this study, we report our experience with n-butyl-2-cyanoacrylate (BC) in patients with large gastric varices. "
4.	Vasopressins (Vasopressin)IBA 11/01/2011 - "The aim of this study was to evaluate gastric myoelectric activity and autonomic activity in patients with esophageal varices treated by an analogue of vasopressin. " 11/01/1995 - "The aim of this study was to elucidate the features of hemodynamic response to vasopressin in the gastroesophageal collateral vein in patients with esophageal varices. " 07/01/1984 - "Vasopressin perfusion of esophageal varices in cirrhotic patients: cineangiographic study." 10/01/1996 - "These data support the view that vasopressin is able to selectively reduce esophageal varices blood flow. " 10/01/1996 - "In splanchnic circulation, vasopressin decreased portal vein (-32 +/- 3%, p < 0.01), superior mesenteric artery (-30 +/- 2%, p < 0.01), and esophageal varices flow velocity (-48 +/- 5%, p < 0.01). "
5.	Sclerosing Solutions (Sclerosing Agents)IBA 12/01/1992 - "This study suggests that the two sclerosants have equal efficacy for treating patients with esophageal varices. " 10/01/2012 - "Randomized controlled trials are required to evaluate the superiority of this procedure over other methods of treating gastric varices and to determine which sclerosant should be used. " 06/01/1992 - "Experimental study on the effects of sclerosants for esophageal varices on blood coagulation, fibrinolysis and systemic hemodynamics." 03/01/1990 - "A comparative evaluation of sclerosants for esophageal varices: a prospective randomized controlled study." 12/01/1984 - "The purpose of this study is to know the systemic distribution of sclerosant injected into esophageal varices. "
6.	Somatostatin (Somatotropin Release-Inhibiting Factor)IBA 02/01/1987 - "[Somatostatin in the treatment of hemorrhaging esophago-gastric varices. " 06/01/1994 - "Is somatostatin effective in the treatment of acute bleeding caused by esophageal varices?" 01/01/1991 - "In this study we evaluate the efficacy of somatostatin (ST) versus balloon tamponade (BT) in controlling bleeding from esophageal varices. " 03/29/1979 - "Somatostatin not helpful in bleeding esophageal varices." 04/22/1996 - "[Randomized trial and meta-analysis of somatostatin versus placebo in bleeding esophageal varices]."
7.	Tissue Adhesives (Tissue Adhesive)IBA 08/01/2011 - "CT portography with gastric variceal volume measurements in the evaluation of endoscopic therapeutic efficacy of tissue adhesive injection into gastric varices: a pilot study." 07/01/2012 - "Injection of tissue adhesive under endoscopic guidance for treatment of gastric varices is convenient, safe and effective." 09/01/2019 - "Tissue adhesive injection is the first-line treatment for gastric varices rebleeding. " 02/20/2019 - "The correlation between CT volume of gastric varices and the amount of tissue adhesive was evaluated by Spearman rank correlation coefficient and Univariate linear regression analysis. " 11/01/2013 - "MUP sonography is useful for the evaluation of the adequacy of tissue adhesive obturation of gastric varices that may reduce the probability of rebleeding."
8.	ThrombinFDA Link 01/01/2023 - "The use of EUS-guided embolisation coils combined with thrombin injection in gastric varices has been shown to be safe and effective. " 08/01/2014 - "Thirty patients received thrombin injection for gastric varices between December 2008 and January 2013. " 08/01/2014 - "We analysed our experience using endoscopic human thrombin injection for gastric varices in a tertiary referral liver unit. " 08/01/2014 - "Outcomes of endoscopic human thrombin injection in the management of gastric varices." 11/07/2012 - "(1) Gastric varices, an average of 15.2 mL of thrombin was used per patient. "
9.	ethanolamine oleate (Ethamolin)FDA Link 02/01/2015 - "The purpose of this study was to investigate the short-term effects of new transjugular retrograde obliteration (TJO) without the use of ethanolamine oleate for gastric varices with a gastrorenal shunt. " 01/01/1997 - "The aim of the study was to investigate hematological and arterial and venous gasometric parameters before and after injection of 5% ethanolamine oleate (EO) to the esophageal varices. " 08/01/2017 - "To evaluate 90-day outcomes after balloon-occluded retrograde transvenous obliteration (BRTO) with ethanolamine oleate (EO) in patients with gastric varices (GVs). " 02/01/2015 - "New transjugular retrograde obliteration without the use of ethanolamine oleate for gastric varices." 05/01/2005 - "Complications were evaluated in 38 patients who had fundic gastric varices and 43 B-RTO procedures during injection of ethanolamine oleate (phase 1), within 4 h after injection (phase 2), 24 h after injection (phase 3), and from 24 h to 10 days after injection (phase 4). "
10.	Polidocanol (Laureth)FDA Link 01/01/2017 - "Polidocanol foam was injected into the gastric varices or the inferior mesenteric vein during the surgery. " 12/01/2012 - "Variant treatment for gastric varices with polidocanol foam using balloon-occluded retrograde transvenous obliteration: a pilot study." 07/01/2012 - "Twenty consecutively registered patients with gastric varices underwent balloon-occluded retrograde transvenous obliteration with polidocanol foam. " 12/01/1988 - "Effect of low dosage of polidocanol in treatment of esophageal varices in cirrhotic patients." 01/01/1983 - "[Experiences with fiber endoscopy sclerosing of esophageal varices with polidocanol]."

Therapies and Procedures

1.	Sclerotherapy 11/01/2000 - "Repeated injection sclerotherapy eradicated esophageal varices in most long-term patients. " 01/01/1985 - "Injection sclerotherapy is one of the most effective treatments for esophageal varices. " 01/01/1999 - "Improved long-term survival following complete eradication of esophageal varices by sclerotherapy." 12/01/1997 - "These results suggest that gastrorenal veins play an important role in the protection against recurrent esophageal varices after sclerotherapy, while the protective role of paraesophageal veins appears to be small." 04/01/1991 - "After surgery, these five continued sclerotherapy until the esophageal varices were eradicated. "
2.	Ligation 02/01/2002 - "Endoscopic variceal ligation is highly effective in obliterating esophageal varices in children. " 09/01/1999 - "This study was conducted to determine whether prophylactic banding ligation is beneficial for cirrhotic patients with high-risk esophageal varices. " 03/01/2001 - "Our results indicate that endoscopic ligation of esophageal varices combined with APC is superior to ligation alone. " 09/01/2013 - "[Therapeutic efficacy of endoscopic variceal ligation to treat gastric varices: a study of 63 consecutive cases]." 09/01/2013 - "To investigate the therapeutic efficacy of endoscopic variceal ligation (EVL) for treating various types of gastric varices (GV) by reviewing patient cases in order to identify the influencing factors of EVL-related recurrence and rebleeding. "
3.	Therapeutics 02/01/2011 - "PH is defined by an increase of HVPG values above the normal upper limit of 5 mm Hg, while clinically significant PH is defined by an HVPG to ≥10 mm Hg. Although measurement of HVPG potentially has several applications, in clinical practice its major use has been related to the assessment of hemodynamic response to pharmacological therapy, in order to evaluate the efficacy of treatment and to predict the risk of rebleeding from esophageal varices. " 07/01/2002 - "Endoscopic injection scleroligation therapy completely eradicated gastric varices in both patients following partially successful embolization therapy. " 05/01/2010 - "We conclude that the combined therapy using PSE and TJO is an effective treatment for gastric varices from the portal hemodynamic point of view." 04/01/2022 - "This meta-analysis suggests that EUS-guided combination therapy is safe and effective for patients with gastric varices and should be considered in the clinical management of these patients." 07/01/2021 - "Combined PTO and BRTO therapy is safe and effective for the treatment of gastric varices that cannot be managed otherwise."
4.	Surgical Portasystemic Shunt (Portosystemic Shunt) 06/01/2011 - "Balloon-occluded retrograde transvenous obliteration (B-RTO) is a novel interventional technique for gastric varices and portosystemic shunts and also is effective for increasing portal vein flow. " 02/01/2016 - "Some studies have suggested that the presence of spontaneous portosystemic shunts is inversely associated with the appearance of large esophageal varices. " 05/01/2023 - "Plug-assisted retrograde transvenous obliteration via alternative portosystemic shunts is effective and technically feasible in the treatment of gastric varices." 11/01/2022 - "Combined Transjugular Intrahepatic Portosystemic Shunt Creation plus Transvenous Obliteration for Treatment of Gastric Varices: Initial Technical and Safety Outcomes from a Single-Center Prospective Pilot Study." 09/01/2022 - "More specifically, EUS-guided Porto-systemic Pressure Gradient (EUS-PPG) measurement, EUS-guided coil and glue embolization of gastric varices, EUS-guided paracentesis and EUS-guided intrahepatic portosystemic shunt creation (IPSS) will be discussed in-depth with regard to clinical status, available data and technical considerations."
5.	Transjugular Intrahepatic Portasystemic Shunt 08/01/2007 - "TIPS proved more effective than glue injection in preventing rebleeding from gastric varices, with similar survival and frequency of complications." 07/01/1993 - "TIPSS can be life saving and is effective in controlling variceal haemorrhage and rebleeding from oesophageal or gastric varices and portal hypertensive gastropathy. " 04/01/2016 - "PubMed, Embase, and Cochrane Library were searched for both randomized controlled trials and cohort studies concerning BRTO compared with TIPS in the treatment of gastric varices from their inception to April 26, 2015. " 10/04/2023 - "Top Tips for EUS Guided Gastric Varices Embolization." 07/03/2019 - "Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO."