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- W4385196686 abstract "Background and Aim: Acute variceal Bleeding (AVB) is a major cause of mortality in patients with cirrhosis. Refractory variceal bleed is usually either dur to failure of secondary prophylaxis or post endoscopic variceal ligation (EVL) ulcers. Patients refractory to standard endoscopic therapy need further interventions with balloon tamponade or Sx-Ella Danis Stent placement. The aim was to evaluate the efficacy of Sx-Ella Danis stent in refractory variceal bleed. Methods: Cirrhotic patients receiving Sx-Ella Danis stent for VB at single tertiary care centre were included in this retrospective analysis. We aimed to assess technical success rate, migration of stent, rebleeding, and bleeding related mortality at 6 weeks. Results: A total of 8 patients [mean age 46.9(17.8)] with refractory variceal bleed were included. Mean MELD Na score was 23.6(8.8). Three had hepatocellular carcinoma (HCC), one Acute on chronic liver failure, one budd-chiari syndrome (BCS) and one had EHPVO. 50% had portal vein thrombosis (PVT). Most common reason for refractory bleed was post EVL ulcers (75%). Sx-Ella Danis stent was placed with technical success of 100 %. Immediate bleed control was achieved in 75% (6/8) of patients. In three patients, SEMS had internally migrated which was successfully repositioned in two and removed in one as bleed was controlled. Only 37.5% (3/8) of patients did not experience any rebleeding within six weeks after SEMS removal. Overall, 50% of patients died within 6 weeks of stents placement (3/8 with stent insitu). Causes of death were sepsis, advanced HCC with PVT and acute cerebral infarction in BCS. Rescue TIPS was done in 1 patient who later underwent liver transplant (LT). Conclusion: SEMS is safe and effective in controlling refractory VB. Presence of PVT is associated with recurrent VB. Early use of TIPS as bridge to LT may be considered to prevent refractory VB related mortality." @default.
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- W4385196686 date "2023-01-01" @default.
- W4385196686 modified "2023-09-30" @default.
- W4385196686 title "Outcomes after placement of a SXELLA oesophageal stent for refractory variceal bleeding" @default.
- W4385196686 doi "https://doi.org/10.1016/j.jceh.2023.07.290" @default.
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