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Through a period from 1981 to 1996 127 roentgen-endovascular embolization of gastric veins were carried out in 95 patients for portal hypertension complicated by esophagogastric bleeding or in its threatening relapse. Group 1 consisted of 73 patients, to whom endovascular treatment was carried out urgently at the background of continuing hemorrhage, in 52 patients--it was delayed and in 21 patients in the nearest posthemorrhagic period. In 73 patients bleeding resulting from embolization was stopped. In the earliest postembolization period recurrence of hemorrhage developed in 6 patients, thus initial hemostatic effect of embolization made up 91.8%, and survival rate--74% (54 from 73 patients of the 1-st group were discharged from the clinic). Group 2 consisted of 22 patients to whom embolization of gastric veins was carried out as an elective procedure. There were bleedings in the anamnesis in the patients of the latter group, and varicose veins of the esophagus with trophic disturbances in esophageal mucosa manifested real treat of the hemorrhage. The survival rate in this group of patients made up 95.5%. The analysis of the results of elective endovascular embolization of gastric veins revealed more favourable results in the nearest postembolization period, than in urgent procedures. Far off results of embolization of gastric veins were followed up in 61 patients (43 patients of the 1st group and 18 patients of the 2nd group). Index of survival up to 6 months made up 87.8%, up to 12 months--80.5%, up to 3 years--57.5% and up to 6 years--19.6%. Hemostatic effect up to 6 months made up 100%, to 12 months--84.6%, to 3 years--54.9%, to 6 years--15.6%.

An experience with using endovascular venous embolization in 53 patients with bleeding from varices of esophageal veins is presented. Transhepatic, transsplenic and laparotomic accesses were used. Embolization of the gastric veins was fulfilled with nonlysing materials--teflon velour in combination with metallic spirals. The results obtained proved to be better than those known from the literature.

The work is based on a comparison of data gained in experiments with the results of clinical examination of a large group of patients in the late-term period after endovascular occlusion of a patent ductus arteriosus (PDA). The regular features of the course of the morphological process in the zone of the PDA after implantation of a botallo-occluder into it were studied. Clinico-morphological parallels were made. The high efficacy and reliability of the new method of endovascular treatment of PDA, developed at the Moscow Second Medical institute, was substantiated morphologically and confirmed clinically.

Endovascular occlusion of the veins which carry the retrograde outflow of blood from the portal system into the system of the superior caval vein through the varicose dilated esophageal veins is known to be one of the most effective methods to stop profuse bleedings due to a disturbed integrity of the varicose dilated veins of the esophagus. It is thought to be expedient to add injections of thrombin to embolization. When performing embolization of the splenic artery it is necessary to exclude possible development of the resulting collateral blood flow via the spleen.

The arterial catheter embolization was used in 11 of 14 patients with profuse gastroduodenal hemorrhages. The results showed high efficiency of the method. The described method, the level of the occlusion thus obtained allowed avoiding possible complications and gave good hemostatic effect. The authors discuss the indications for the endovascular catheter embolization. An original method of embolization of the left ventricular artery is described.