Interventional radiology and endoscopic therapy for recurrent esophageal varices

Background/Aims: We investigated the impact long-term prognosis of combined interventional radiology and endoscopic therapy in patients with esophagea l varices. Methodology: Patients with recurrent esophageal varices underwent treatment as follows: 54 were treated with endoscopic therapy alone and 32 underwent endoscopic therapy plus interventional radiologic procedures. Primary endp oints during 5-year follow-up included recurrent bleeding, second retreatme nt, and death. Results: The bleeding rates were 11.1% in the endoscopy group, and 9.4% in the combined therapy group. Second retreatment rates at 1 year, 3 years, an d 5 years in the endoscopy group and combined therapy group were 25.4% and 17.2%, 70.2% and 39.3%, and 85.0% and 69.6%, respectively. The second retre atment rates in the combined therapy group were significantly reduced compa red to the endoscopy alone group (P = 0.05). Cumulative retreatment rates i n Child's class C cases were significantly lower in the combined therapy gr oup than in the endoscopy group (P = 0.01). Survival at 3 years was 97.1% i n the endoscopy group and 92.0% in the combined therapy group, and 5-year s urvival was 79.1% and 83.6%, respectively. Conclusions: The combination of interventional radiologic and endoscopic th erapy is highly effective and improves long-term prognosis in patients with recurrent esophageal varices.