Transvenous obliteration for gastric varices
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 10 sources, which was discussed by the committee. The evidence included 3 systematic reviews and meta-analyses, 1 randomised controlled trial, 1 cohort study, and 5 case series. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: reduction in bleeding, survival, quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be: bleeding, embolisation of sclerosant or device, encephalopathy, worsening of portal hypertension.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 This procedure may be done with transjugular intrahepatic portosystemic shunt insertion.
3.6 There are several different approaches to doing this procedure.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
June 2022
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