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  • Title: Bleeding from esophageal varices exacerbated by splenic arterial-venous fistula: complete transcatheter obliterative therapy.
    Author: Keller FS, Rösch J, Dotter CT.
    Journal: Cardiovasc Intervent Radiol; 1980; 3(3):97-102. PubMed ID: 6966536.
    Abstract:
    A cirrhotic patient who had previously undergone both mesocaval shunting and transthoracic esophageal and gastric devascularization with splenectomy (Sugiura procedure) presented with recurring intractable variceal hemorrhage. Diagnostic visceral angiography demonstrated a large splenic arterial-venous fistula and gastroesophageal varices. Transarterial occlusion of the fistula and transheptic obliteration of the varices successfully done at one sitting prevented further bleeding. Follow-up angiography nine months later revealed persistent occlusion of the previous fistula and no evidence of esophageal varices.
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