self-expandable metal stents in the treatment of acute esophageal variceal bleedingself-expandable金属支架治疗急性食道静脉曲张的出血.pdfVIP

Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2011, Article ID 910986, 6 pages doi:10.1155/2011/910986 Review Article Self-Expandable Metal Stents in the Treatment of Acute Esophageal Variceal Bleeding ` Angels Escorsell and Jaime Bosch Intensive Care Unit and Hepatic Hemodynamic Lab, Liver Unit, Hospital Clınic IDIBAPS, University of Barcelona and Centro de ´ Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), 08036 Barcelona, Spain ´ ´ ´ ` Correspondence should be addressed to Angels Escorsell, aescor@clinic.ub.es Received 16 May 2011; Accepted 11 August 2011 Academic Editor: A. Andoh ` Copyright © 2011 A. Escorsell and J. Bosch. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute variceal bleeding (AVB) is a life-threatening complication in patients with cirrhosis. Hemostatic therapy of AVB includes early administration of vasoactive drugs that should be combined with endoscopic therapy, preferably banding ligation. However, failure to control bleeding or early rebleed within 5 days still occurs in 15–20% of patients with AVB. In these cases, a second endo- scopic therapy may be attempted (mild bleeding in a hemodynamically stable patient) or we can use a balloon tamponade as a bridge to definitive derivative treatment (i.e., a transjugular intrahepatic portosystemic shunt). Esophageal balloon tamponade