[Trends in endovascular treatment and prevention of portal bleeding]. / Tendentsii v rentgenendovaskulyarnom lechenii i profilaktike portal'nykh krovotechenii (obzor literatury).

Bleeding from esophageal and gastric varices is a major factor of mortality in patients with portal hypertension. The gold standard for diagnosis of portal hypertension is hepatic venous pressure gradient determining the treatment algorithms and risk of recurrent bleeding. Combination of endoscopic methods and therapy is limited by varix localization and not always effective. In these cases, endovascular bypass and decoupling techniques are preferred. Early endovascular treatment of portal bleeding is effective for hemostasis and higher transplantation-free survival of patients. Early transjugular intrahepatic portosystemic bypass should be associated with 8-mm covered stents of controlled dilation. Combination of endovascular techniques reduces the complications of each technique and potentiates their positive effect. Endovascular treatment and prevention of portal bleeding should be determined by anatomical features of portal venous system.

[Endoscopic sclerotherapy of esophageal varicose veins in portal hypertension].

The results of endoscopic sclerotherapy (EST) in the patients with portal hypertension (PH) are analyzed. Efficacy of methods in the treatment of gastroesophageal varicosity in urgent situations (bleeding) and "cold" period was evaluated. Schemes of staged minimally-invasive surgical correction of PH syndrome are described. Etoxisclerol is regarded as the most appropriate sclerosant. It is concluded that EST is an effective method of treatment in PH, it is alternative to "open" abdominal surgery and may improve results of treatment in this group of patients.