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Die endoskopische Blutstillung richtet sich nach der Lokalisation: \u00d6sophagusvarizen werden bevorzugt mittels Gummibandligatur behandelt, Fundus- bzw. gastrische Varizen mittels (n-Butyl-2-)Cyanoacrylat-Injektion. In spezialisierten Zentren erg\u00e4nzt die Endohepatologie das Spektrum: EUS-gesteuerte Coil-Implantation kombiniert mit Cyanoacrylat erm\u00f6glicht eine gezielte Obliteration gastrischer Varizen (GOV2, IGV), besonders bei fehlender TIPS-Option. Hochrisikopatienten (Child-Pugh B &gt;7 mit aktiver Blutung in der Indexendoskopie oder Child-Pugh C &lt;14) profitieren bei fehlenden Kontraindikationen von einem pr\u00e4emptiven TIPS innerhalb von 72 Stunden. Bei prim\u00e4rem Therapieversagen sind fr\u00fch Salvage-TIPS-Eignung und ggf. Zentrumstransfer zu pr\u00fcfen; als Bridging bei refrakt\u00e4rer \u00d6sophagusvarizenblutung dient ein voll gecoverter selbstexpandierender \u00d6sophagusmetallstent. Bei fehlender TIPS- und EUS-Option gewinnt, bei geeigneter Anatomie insbesondere mit gastrorenalem Shunt, die BRTO f\u00fcr GOV2, isolierte gastrische und ektope Varizen an Bedeutung.<\/jats:p>","DOI":"10.1055\/a-2894-2004","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T22:39:39Z","timestamp":1784846379000},"source":"Crossref","is-referenced-by-count":0,"title":["Endoskopisch-interventionelle Therapie der akuten varik\u00f6sen Blutung: Endoskopie, EUS, TIPS und BRTO"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-9956","authenticated-orcid":false,"given":"Michael","family":"Praktiknjo","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum M\u00fcnster, NRW, Germany","place":["M\u00fcnster"],"department":["Medizinische Klinik B"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Meyer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Bonn, NRW, Germany","place":["Bonn"],"department":["Klinik f\u00fcr Diagnostische und Interventionelle Radiologie"]},{"name":"Gemeinschaftsklinikum Mittelrhein gGmbH, RP, Germany","place":["Koblenz"],"department":["Diagnostische und Interventionelle Radiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100240","article-title":"Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018)","volume":"12","author":"W Gu","year":"2022","journal-title":"Lancet Reg Health Eur"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1002\/hep.1840160607","article-title":"Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients","volume":"16","author":"SK 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