Transhepatic embolization in patients with acute variceal hemorrhage.

Control of acute variceal bleeding by transhepatic embolization was investigated in 14 patients with alcoholic liver disease. In these patients hemorrhage was unresponsive to general supportive measures, intravenous vasopressin and balloon tamponade. Embolization was performed using Gelfoam and a synthetic polymer, bucrylate. Acute hemorrhage was arrested in 86 percent of patients. Rebleeding after transhepatic embolization occurred in 35 percent of patients. There were three deaths from intraabdominal hemorrhage related directly to transhepatic embolization (21 percent). Six patients (43 percent) left the hospital alive. In a group of cirrhotic patients in whom transhepatic embolization was employed after traditional modes of therapy had failed to control variceal hemorrhage, mortality and rebleeding rates were high.