Alternative treatment for bleeding peristomal varices: percutaneous parastomal embolization.
PURPOSE: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. METHODS: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated. RESULTS: Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days). CONCLUSION: This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.
Pabon-Ramos, WM; Niemeyer, MM; Dasika, NL
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