Pulmonary hemodynamic changes after intravariceal sclerotherapy with absolute alcohol

To investigate whether alcohol used as variceal sclerosant has any effect on pulmonary hemodynamics, 14 patients with portal hypertension received intravariceal injections of absolute alcohol. Six additional patients were injected with equivalent volumes of saline and they served as controls. After intravariceal injection of absolute alcohol (8 ml in 12 patients and 12 ml in 2 patients), mean +/- SD pulmonary artery pressure was seen to increase significantly (p less than 0.01) at 1 and 5 min and return to basal level by 15 min. Similar changes in pulmonary arterial pressure were seen after intravariceal injection of saline; the difference in the rise in pulmonary arterial pressure between the two groups was not significant. The pulmonary capillary-wedged pressure and systemic blood pressure did not change significantly after intravariceal injection of alcohol. Absolute alcohol in the amount usually used for sclerotherapy has minimal and transient effects on pulmonary hemodynamics and, in this respect, it appears to be a relatively safe sclerosant.