Ces radiol. 2026, 80(2):82-88 | DOI: 10.55095/CesRadiol2026/018

Embolization of bleeding gastric varix using transsplenic approach - case reportCase report

Vendelín Chovanec^{1, 2}, Štěpán Šembera^{2, 3}, Igor Guňka^{2, 4}, Pavel Ryška^{1, 2}, Ondřej Renc^{1, 2}, Jan Raupach^{1, 2}

¹ Radiologická klinika FN, Hradec Králové

² Lékařská fakulta Univerzity Karlovy, Hradec Králové

³ 2. interní gastroenterologická klinika FN, Hradec Králové

⁴ Chirurgická klinika FN, Hradec Králové Korespondenční adresa:

Chovanec V, Šembera Š, Guňka I, Ryška P, Raupach J. Embolization of bleeding gastric varix using transsplenic approach - case report



The authors present a case of a female patient with bleeding gastric varices due to portal hypertension, which were embolized using a transsplenic approach. Endoscopic treatment had failed, and the creation of a transjugular intrahepatic portosystemic shunt (TIPS) was not feasible due to anatomical conditions (high-positioned liver and horizontal course of the hepatic veins). An attempt at balloon-occluded retrograde transvenous obliteration (BRTO) was also performed but proved unsuccessful due to the large diameter of the splenogastrorenal shunt and the inability to achieve its balloon occlusion. Subsequently, under general anesthesia, embolization of the varix was performed using a combination of coils and tissue cyanoacrylate glue via a transsplenic approach. There was no recurrence of bleeding after embolization during 6 months follow up. Gastric variceal bleeding is a potentially life-threatening condition. When endoscopic treatment fails, radiological methods are employed, including TIPS with antegrade varix embolization, BRTO and its modifications, and in recent years, antegrade embolization via a transsplenic or transhepatic approach. Transsplenic antegrade variceal embolization is suitable for patients in whom a transhepatic approach is not possible.

Keywords: portální hypertenze, krvácení, žaludeční varix, embolizace, TIPS, transsplenický přístup.

Accepted: March 15, 2026; Published: July 1, 2026  Show citation