ethamolin and Varicose-Veins

To evaluate techniques and efficacy of retrograde transvenous obliteration for the treatment of duodenal varices associated with mesocaval collateral pathway.. Six consecutive cases of large/growing or ruptured duodenal varices treated by retrograde transvenous obliteration were retrospectively reviewed. Selective balloon-occluded retrograde transvenous obliteration (B-RTO) with 5% ethanolamine oleate (EO) was performed in all cases. When EO could not be sufficiently stagnated in the varices, additional/alternative techniques were performed, including coil embolization of afferent vein or intravariceal injection of n-butyl-2-cyanoacrylate (NBCA). Clinical findings, anatomic features of duodenal varices, obliteration techniques, complications, posttherapeutic computed tomography (CT) findings, and follow-up endoscopic findings were investigated.. All duodenal varices were located at the second/third junction of the duodenum and were fed by single (n = 1) or multiple (n = 5) pancreaticoduodenal veins. One varix fed by a single afferent vein was successfully treated by simple selective B-RTO technique alone. The other five cases required coil embolization of afferent vein (n = 1) or intravariceal injection of NBCA (n = 4) because sclerosant was not sufficiently stagnated in the varices. CT 1 week after the procedure showed complete occlusion of the varices in all cases. A duodenal ulcer at the variceal site developed in one patient and was successfully treated by medication. Follow-up endoscopy showed disappearance of varices in all cases, and no recurrence was observed during follow-up.. Retrograde transvenous obliteration is an effective technique for the treatment of duodenal varices. However, additional/alternative techniques are required for successful treatment because of the complex anatomic features of duodenal varices.

Topics: Aged; Aged, 80 and over; Balloon Occlusion; Collateral Circulation; Duodenoscopy; Duodenum; Embolization, Therapeutic; Enbucrilate; Female; Humans; Male; Middle Aged; Oleic Acids; Predictive Value of Tests; Retrospective Studies; Sclerosing Solutions; Splanchnic Circulation; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Varicose Veins

We present a patient with continuous melena, diagnosed as rectal varices bleeding. She had a history of esophageal varices, which was treated by endoscopic ligation therapy. Eight years after the treatment of esophageal varices, the continuous melena began. Colonoscopic examination showed that the melena was caused by rectal varices, which were so severe that they could not be treated by either endoscopic sclerotherapy or surgical devascularization. Taking into considering the overall risk of treating rectal varices, we chose the approach of double balloon-occluded embolotherapy (DBOE) with 5% ethanolamine oleate with iopamodol as a liquid embolic material. DBOE is one of the interventional radiology techniques (Morita et al., Acta Hepatol Jpn 1994;35:109-120), but in this case was a completely new and novel clinical procedure for rectal varices. After the DBOE therapy, the condition of rectal varices was markedly improved. Thus, DBOE might be a new tool for treating inoperable rectal varices.

Topics: Aged; Chemoembolization, Therapeutic; Embolization, Therapeutic; Female; Humans; Iopamidol; Oleic Acids; Rectal Diseases; Sclerosing Solutions; Tomography, X-Ray Computed; Varicose Veins

The purpose of this paper is to describe our experience with endovascular obliteration of duodenal varices in patients with liver cirrhosis and portal hypertension. Balloon-occluded transvenous retrograde and percutaneous transhepatic anterograde embolizations were performed for duodenal varices in five patients with liver cirrhosis, portal hypertension, and decreased liver function. All patients had undergone previous endoscopic treatments that failed to stop bleeding and were poor surgical candidates. Temporary balloon occlusion catheters were used to achieve accumulation of an ethanolamine oleate-iopamidol mixture inside the varices. Elimination of the varices was successful in all patients. Retrograde transvenous obliteration via efferent veins to the inferior vena cava was enough to achieve adequate sclerosant accumulation in three patients. A combined anterograde-retrograde embolization was used in one patient with balloon occlusion of afferent and efferent veins. Transhepatic embolization through the afferent vein was performed in one patient under balloon occlusion of both efferent and afferent veins. There was complete variceal thrombosis and no bleeding was observed at follow-up. No major complications were recorded. Endovascular obliteration of duodenal varices is a feasible and safe alternative procedure for managing patients with portal hypertension and hemorrhage from this source.

Topics: Aged; Balloon Occlusion; Catheterization; Duodenum; Feasibility Studies; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Haptoglobins; Humans; Hypertension, Portal; Iopamidol; Liver Cirrhosis; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Treatment Outcome; Varicose Veins

The objective of this study was to report and discuss the results from treatment of benign oral vascular lesions with ethanolamine oleate.. Twenty-seven patients with 30 examples of oral vascular malformation, hemangioma, or varix were treated with intralesional injections of 1.25% or 2.5% ethanolamine oleate at an interval of 15 days between each application. The lesions were divided into 2 categories: (1) lesions of 20 mm or less and (2) those greater than 20 mm. Subsequently, the Mann-Whitney test was used a means of statistical analysis.. Although the number of injections varied from patient to patient, all lesions responded to the treatment, showing total clinical regression. Lesions of 20 mm or less needed a lesser number of applications than those greater than 20 mm (P < .05).. Ethanolamine oleate is a 100% effective sclerosant agent for treatment of benign oral vascular lesions. In this study, no difference was found between the 2 concentrations applied.

Topics: Adolescent; Adult; Aged; Arteriovenous Malformations; Child; Female; Hemangioma; Humans; Injections, Intralesional; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Neoplasms, Vascular Tissue; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Statistics, Nonparametric; Varicose Veins; Vascular Diseases

To describe the effectiveness and safety of a sclerotherapy protocol with 5% ethanolamine oleate (EO) at 0.1 mL/3 mm for oral vascular anomalies (OVAs). Our hypothesis is that EO applied at a concentration of 5% may decrease the number of sessions necessary for clinical healing.. We describe a cohort of 15 consecutive patients. OVAs <20 mm were included. Clinical data of the OVAs were collected. Descriptive and bivariate statistical analyses were performed.. Fifteen of the 19 OVAs were varicosities and the lower lip was the most affected site (n = 7). The median size was 6 mm, and one session was required in 89.5% of cases for clinical healing within 28 days. The pain/burning score was low (<2) for most lesions (63.1%) and the degree of satisfaction was high (>8) for all OVAs. The number of applications, final volume of drug and time to resolution differed significantly according to the size of the anomaly.. The protocol with 5% EO was shown to be effective and safe to treat OVAs <20 mm, and with a decrease in the number of sessions, volume and time to resolution, without complications and with high patient satisfaction.

Topics: Aged; Aged, 80 and over; Arteriovenous Malformations; Cohort Studies; Female; Humans; Lip; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Treatment Outcome; Varicose Veins; Vascular Diseases

A 56-year-old male with alcohol-induced liver cirrhosis developed rectal varices. He had a prior history of treatment for esophageal varices with endoscopic variceal ligation. Despite the repeated treatment for rectal varices with endoscopic variceal ligation, endoscopic injection sclerotherapy, and surgery, the bleeding from the rectal varices could not be controlled. Multidetector-row computed tomography and 3D-angiography revealed the hemodynamic profile of the rectal varices. We next approached the rectal varices through the umbilical vein on the abdominal wall, and successfully embolized the varices continuing from the inferior mesenteric vein using coils and a 5% solution of ethanolamine oleate with iopamidol.

Topics: Endoscopy; Gastrointestinal Hemorrhage; Humans; Injections, Intralesional; Male; Middle Aged; Multidetector Computed Tomography; Oleic Acids; Rectal Diseases; Rectum; Sclerosing Solutions; Sclerotherapy; Umbilical Veins; Varicose Veins

We report a case of anal variceal bleeding successfully treated with endoscopic injection sclerotherapy (EIS). A 64-year-old man with alcoholic liver cirrhosis was hospitalized because of repeated anal bleeding. Colonoscopy revealed external anal varices connecting with rectal varices. Three days after admission, external anal variceal bleeding was observed. Angiography revealed that the anorectal varices formed by hepatofugal inferior mesenteric vein drained into the internal iliac vein. On angiography, the variceal blood flow rate was extremely low, therefore we performed EIS. Seven days after therapy, thrombosis of anorectal varices was observed.

Topics: Anus Diseases; Colonoscopy; Humans; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Varicose Veins

A 75-year-old man with portal hypertension was referred to our institution because he suddenly began to pass a large amount of tarry stool. Arterial portography and computed tomography (CT) during arterial portography via the superior mesenteric artery, using a unified 64-slice multidetector row CT and angiography system, revealed bleeding ileal varices. The varices were supplied blood by a single ileal vein and drained by dilated veins in the abdominal wall. The bleeding was successfully arrested by performing percutaneous transhepatic sclerotherapy with 12 ml of 5% ethanolamine oleate. The blood flow to the varices was controlled by balloon occlusion, and microcoils were inserted into the varices and supplying vein. No complications or rebleeding occurred during the 13-month follow-up period, and CT images obtained during follow-up showed that the varices had disappeared.

Topics: Abdomen; Aged; Balloon Occlusion; Contrast Media; Diagnosis, Differential; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Ileum; Image Enhancement; Iopamidol; Male; Oleic Acids; Portography; Postoperative Complications; Reoperation; Sclerosing Solutions; Sclerotherapy; Tomography, X-Ray Computed; Treatment Outcome; Varicose Veins

We report a case of successful embolization of jejunal varices that were the cause of massive gastrointestinal bleeding from a choledochojejunostomy site, resulting from obstruction of the extrahepatic portal vein. A 42-year-old man who had undergone choledochojejunostomy for intrahepatic and choledochal stones was readmitted after he started passing massive dark bloody stools. Gastrointestinal endoscopic examination and angiography could not identify the source of bleeding. Percutaneous transhepatic portography showed obstruction of the right branches of the portal vein. The formation of jejunal varices at the site of choledochojejunostomy was revealed by portography and by cholangioscopy, suggesting the varices as the cause of massive bleeding. Bleeding could not be controlled long-term by cholangioscopic sclerosing therapy. We finally stopped the bleeding by embolizing a jejunal vein to the afferent loop.

Topics: Adult; Angioscopy; Choledochostomy; Embolization, Therapeutic; Gastrointestinal Hemorrhage; Humans; Iopamidol; Jejunal Diseases; Jejunum; Male; Oleic Acids; Portal Vein; Varicose Veins

Topics: Collateral Circulation; Contrast Media; Endoscopy, Gastrointestinal; Endosonography; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Iopamidol; Jejunum; Male; Middle Aged; Oleic Acids; Portasystemic Shunt, Transjugular Intrahepatic; Sclerosing Solutions; Sclerotherapy; Stents; Tomography, X-Ray Computed; Varicose Veins

We report a case of a 50-year-old man with a medical history of alcoholic cirrhosis, in addition to esophagogastric and duodenal varices (DV), who was transferred to our institution because of hemorrhagic DV. Emergent esophagogastroduodenoscopy showed hemorrhagic varices in the horizontal portion of the duodenum. Abdominal contrast-enhanced CT showed hemodynamics of DV derived from anastomosis between the superior mesenteric vein and right renal vein. Cyanoacrylate was injected into the DV. Subsequently, 5% ethanolamine-oleate was injected endoscopically as a sclerosant into the DV feeding vein. Radiographic fluoroscopic findings revealed that the injected cyanoacrylate and sclerosant remained, respectively, in the varices and its feeder. Five days later, CT showed that the injected cyanoacrylate occupied the DV, and thrombus formation of the afferent vein led to bifurcation of superior mesenteric vein. This case showed the usefulness of endoscopic injection sclerotherapy using cyanoacrylate and sclerosant for the management of DV.

Topics: Cyanoacrylates; Duodenum; Endoscopy, Digestive System; Gastrointestinal Hemorrhage; Hemodynamics; Humans; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Varicose Veins

Topics: Angiography; Duodenum; Endoscopy, Gastrointestinal; Follow-Up Studies; Humans; Injections, Intralesional; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Tomography, X-Ray Computed; Varicose Veins

We reported a case of varicosities in the buccal mucosa treated with sclerotherapy. The sclerosant agent used was the monoethanolamine oleate. After three sessions the lesions disappeared and the patient is follow-up.

Topics: Endothelium, Vascular; Female; Humans; Injections, Intravenous; Middle Aged; Mouth Diseases; Mouth Mucosa; Oleic Acids; Sclerosing Solutions; Varicose Veins

Topics: Balloon Occlusion; Brain Diseases, Metabolic; Colon; Colonoscopy; Contrast Media; Embolization, Therapeutic; Female; Humans; Iopamidol; Liver Cirrhosis; Middle Aged; Oleic Acids; Radiography; Sclerosing Solutions; Varicose Veins

Caput medusa is a frequent incidental finding in patients with portal hypertension that usually represents paraumbilical vein portosystemic collateral vessels draining into body wall systemic veins. A symptomatic caput medusa was seen in a morbidly obese patient after an umbilical hernia repair, which was fed not by the left portal vein but by the left gastroepiploic vein, in a recurrent adhesed umbilical hernia that likely contained herniated omentum. Refractory hemorrhage from this caput medusa was successfully treated by transjugular intrahepatic portosystemic shunt creation and balloon-occluded variceal sclerosis.

Topics: Hemorrhage; Hernia, Umbilical; Humans; Hypertension, Portal; Male; Middle Aged; Oleic Acids; Omentum; Peritoneal Diseases; Portasystemic Shunt, Transjugular Intrahepatic; Postoperative Complications; Recurrence; Sclerosing Solutions; Sclerotherapy; Stomach; Tissue Adhesions; Varicose Veins

Topics: Aged; Female; Hemorrhage; Humans; Liver Cirrhosis, Biliary; Oleic Acids; Radiography, Interventional; Sclerosing Solutions; Sclerotherapy; Vagina; Vaginal Diseases; Varicose Veins

Topics: Duodenum; Endoscopy, Gastrointestinal; Humans; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Treatment Failure; Varicose Veins

Topics: Aged; Colonic Neoplasms; Colostomy; Female; Hemorrhage; Humans; Oleic Acids; Postoperative Complications; Sclerosing Solutions; Skin; Varicose Veins

Topics: Aged; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Oleic Acids; Rectum; Sclerosing Solutions; Varicose Veins

The purpose of this study is to know the systemic distribution of sclerosant injected into esophageal varices. Sclerotherapy for esophageal varices was performed for 14 times in 11 patients. The patients were divided into two groups according to the content of sclerosant. Seven patients received a total of 9 intravariceal injections (IVI) with 7 to 30ml of 5% ethanolamine oleate (EO) which contained meglumine diatrizoate (Angiographin) and four patients received a total of 5 IVI with 10 to 20ml of 4.5% EO which contained a 10% volume of 99mTcO-4 solution (EO-99mTc). Distribution of injected materials was observed by X-ray fluoroscopy in the former group and by a scintillation camera in the latter. In both methods most of the sclerosant disappeared from the injected site within five minutes leaving a trace in the varices. Then, the sclerosant was disseminated throughout the body via portal vein. When more than 20ml of sclerosant was injected, some flowed into the azygos vin through the periesophageal vin. After IVI the varices showed atrophic changes, though the sclerosant did not stay in the varices.

Topics: Adult; Aged; Esophagus; Female; Humans; Male; Middle Aged; Oleic Acids; Sclerosing Solutions; Tissue Distribution; Varicose Veins

A routine upper gastrointestinal fiberoscope (Olympus GIFK) was used for endoscopic sclerotherapy of varices in 38 patients sedated with I.V. diazepam. It was effective in preventing rebleeding in 30 patients, and greatly reducing the size and number of varices in 31 of the patients. This endoscope needs no additional cuff or sheath for this therapy. It is easier to use and safer than the rigid oesophagoscope. Sodium tetradecyl sulphate is as effective as ethanolamine oleate as a sclerosant and causes no chest pain. Four patients developed a fibrotic lower oesophageal stricture. One patient developed an intramural haematoma that was followed by bacteraemia and death.

Topics: Adolescent; Adult; Aged; Endoscopy; Esophageal and Gastric Varices; Female; Fiber Optic Technology; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Oleic Acids; Prospective Studies; Recurrence; Sclerosing Solutions; Sodium Tetradecyl Sulfate; Stomach; Varicose Veins

Topics: Anaphylaxis; Humans; Injections; Injections, Intravenous; Oleic Acid; Oleic Acids; Sclerosing Solutions; Toxicology; Varicose Veins

Topics: Humans; Oleic Acids; Varicose Veins

Topics: Humans; Hypersensitivity; Oleic Acid; Oleic Acids; Varicose Veins

Topics: Ethanolamines; Humans; Oleic Acids; Varicose Veins

Topics: Blood Pressure; Humans; Kidney; Nephrectomy; Oleic Acids; Sclerosing Solutions; Sclerosis; Sclerotherapy; Varicose Veins