Transvenous obliteration for gastric varices

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 11 sources, which was discussed by the committee. The evidence included 4 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 overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: reduction in bleeding, survival and quality of life.

The professional experts and the committee considered the key safety outcomes to be: bleeding, embolisation of sclerosant or device, encephalopathy and worsening of portal hypertension.

Patient commentary was sought but none was received.

This procedure may be done with transjugular intrahepatic portosystemic shunt insertion.

There are several different approaches to doing this procedure.