4.4 Review

Variceal Bleeding: Beyond Banding

Journal

DIGESTIVE DISEASES AND SCIENCES
Volume 67, Issue 5, Pages 1442-1454

Publisher

SPRINGER
DOI: 10.1007/s10620-022-07425-8

Keywords

Variceal bleeding; Band ligation; Sclerotherapy; Esophageal stent; Coil therapy

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This article highlights alternative therapies for gastric and esophageal variceal bleeding and their potential role in management.
Despite advances in the management of complications of portal hypertension, variceal bleeding continues to be associated with significant morbidity and mortality. While endoscopic variceal band ligation remains first line therapy for treating bleeding and high-risk non-bleeding esophageal varices, alternate therapies have been explored, particularly in cases of refractory bleeding. The therapies being explored include stent placement, hemostatic powder use, over-the-scope clips and others. For gastric variceal bleeding, endoscopic ultrasound-guided therapies have recently emerged as promising interventions for hemostasis. The aim of this article is to highlight these alternative therapies and their potential role in the management of gastric and esophageal variceal bleeding.

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