'Currents and clots'--an approach to the problem of acute variceal bleeding

The Sengstaken-Blakemore tube will frequently control haemorrhage from oesophageal varices but a large proportion of patients rebleed soon after removing the tube and the hospital mortality in these patients is high. It has been demonstrated that the passage of an electric current across a blood vessel wall will precipitate a thrombus on the positively charged electrode, leading to complete occlusion of the vessel. A direct current of 3.2 mA/cm2 of electrode passed for 1 h produced complete occlusion of the femoral vein in the dog, without arterial occlusion or adjacent tissue damage. A system of longitudinal flexible gold-plated strip electrodes was placed around the oesophageal component of a Sengstaken tube. The technique has been applied in 8 poor risk patients with active variceal bleeding; haemorrhage was arrested in 7 of these on removal of the tube.