Table 3.
Saad-Caldwell Type | Feeding Vessels | Gastrorenal Shunt | Endoscopic Correlate | Treatment |
---|---|---|---|---|
Type 1a | LGV | Absent | GOV1s | EVL ± TIPS (with or without trans-TIPS embolization)a |
Type 1b | LGV | Present | GOV1s | EVL ± TIPS (with or without trans-TIPS embolization)a |
Type 2a | PGVs, SGVs | Absent | IGV1s > GOV2s | ECI, ATO |
Type 2b | PGVs, SGVs | Present | IGV1s > GOV2s | RTO ± ATO |
Type 3a | LGV, PGVs, SGVs | Absent | GOV2s > IGV1s | TIPS with embolization, ECI, ATO |
Type 3b | LGV, PGVs, SGVs | Present | GOV2s > IGV1s | RTO ± ATO, EVL ± TIPSa |
aTIPS is recommended for GOV1s and GOV2s (arising from the LGV) refractory to EVL.
ATO, antegrade transvenous obliteration; ECI, endoscopic cyanoacrylate injection; EVL, endoscopic variceal ligation; GOVs, gastroesophageal varices; IGVs, isolated gastric varices; LGV, left gastric vein; PGVs, posterior gastric veins; RTO, retrograde transvenous obliteration; SGVs, short gastric veins; TIPS, transjugular intrahepatic portosystemic shunt.