[Significance of embolization therapy for esophagogastric varices]

To evaluate the efficacy of the embolization therapy (Emb) for varices, we performed endoscopic injection sclerotherapy (EIS) alone and EIS combined with Emb. Various embolizations such as percutaneous transhepatic obliteration, splenic artery embolization and left gastric artery embolization have been employed. The efficacy rates were 76.5% of the patients in the EIS alone and 87.5% in the EIS with Emb group (EIS+Emb). The cumulative percentages of rebleeding at one year and 3 years were 23.1%, 34.6% in EIS alone, and 10.7%, 25.0% in EIS+Emb respectively. Especially in the patients with the Child C, there was significant difference in the efficacy rates: 60.0% (EIS alone) versus 88.9% (EIS+Emb), and recurrence rates within one year: 41.7% (EIS alone) versus 12.5% (EIS+Emb) (p < 0.05) and length of treatment free periods: 9.7 months versus 17.5 months (p < 0.01). After the treatments, improvement of Child's criteria was seen to be better in EIS+Emb than in EIS alone. The similar results have been obtained in the patients with hepatocellular carcinoma and with gastric varices. These results suggest that EIS should be combined with Emb to increase durability and to improve general condition.