Survival after transhepatic embolization of gastro-oesophageal varices

Twenty-five transhepatic embolization procedures were carried out between 1984 and 1989 on 24 patients with life-threatening haemorrhage from gastric or oesophageal varices after conservative methods had failed. There were two deaths related to the procedure and another 17 patients died during the following year. There were five survivors at 1 year, four are alive and well 4 years later, the fifth was lost to follow-up at 2 1/2 years. Survival at 1 year was not affected by a number of factors present at the time of embolization including the underlying liver pathology, the patient's age, platelet count, blood urea, serum bilirubin or the embolization technique. However, survival at 1 year was related to more normal coagulation values (international normalized ratios, INR) P less than 0.005, normal serum aspartate aminotransferase levels (P less than 0.025) and Pugh's grade A (P less than 0.01). We conclude that this procedure can prolong the survival of a small proportion of good risk patients.