Endoscopic ultrasound-guided coil-assisted retrograde transgastric occlusion of shunt efferent for gastric variceal bleeding.

Authors

Rizwan Ahamed, Sasidharan Rajesh, Cyriac Abby Philips, Ajit Tharakan, Shobhit Singh, Tharun Tom, Nibin Nahaaz, Philip Augustine

Published in

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy. Volume 11. Issue 9. Pages 393-396. Epub Apr 29, 2026.

Abstract

EUS-guided therapy for fundal varices targets the gastric shunt or afferent feeders. In cases with multiple feeders, this may not achieve complete obliteration. We aimed to target the single efferent channel in a patient with multiple feeder vessels.
We describe EUS-guided occlusion of the shunt efferent in a patient with gastric variceal bleed and multiple inflow tracts. The efferent was traced from the left renal vein and targeted with coils and cyanoacrylate glue.
Coil plus glue embolization of the shunt efferent achieved complete variceal obliteration. The patient had no further variceal bleeding or decompensation at 6 months. At 1-year follow-up, the patient was asymptomatic; small esophageal varices were noted.
EUS-guided coil-assisted retrograde transgastric occlusion is a safe and effective alternative to interventional radiology-guided therapy of gastric varices in cases with multiple afferents or feeder vessels. Development of new esophageal varices is a recognized limitation and should be monitored.

PMID:
42694995
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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