Gastric variceal bleeding treated through endoscopic ultrasound-guided coiling and N-butyl-2-cyanoacrylate application.

Abstract

OBJECTIVE:

To evaluate efficacy and safety between dual angiotherapy (endocoil plus N-butyl-cyanoacrylate) guided by endoscopic ultrasound) versus N-butyl-cyanoacrylate in the secondary prophylaxis of gastroesophageal varices (GOV).

METHOD:

Prospective non-inferiority study comparing two gastric variceal eradication techniques. We evaluated technical and clinical success, GOV occlusion and eradication, rebleeding, reoperation, GOV-free period, complications, and mortality. Chi square for categorical variables and Student's t for numerical variables with a significance level of 0.05.

RESULTS:

There were 68 patients (average age 55.5 ± 10 years, women 44 (64.7%) and average body mass index 25.7 ± 3.5 kg/m2). The most frequent cause was alcoholic steatohepatitis (58%). Dual therapy had greater technical (100% vs. 94.3%) and clinical (100% vs. 85%) success. Obliteration was faster (100 vs. 79.2%). This group only required one session. The GOV size was 24 ± 14 mm and 1-2 endocoils were placed. The median follow-up was 221 days. The reoperation-free rate was high (100% vs. 94%; p = 0.9).

CONCLUSIONS:

Dual angiotherapy guided by endoscopic ultrasound and cyanoacrylate injection are effective for the eradication of GOV without differences in adverse event rates.

• Authors: Elymir S Galvis-García, Ángel M Zárate-Guzmán, Arturo Reding-Bernal, Sergio Sobrino-Cossío
• Journal: Cirugia y cirujanos (Cir Cir) Vol. 90 Issue S1 Pg. 15-24 ( 2022) ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Embolización guiada por ultrasonido endoscópico con cianoacrilato solo o combinado con endo-coil para las várices gástricas.
• PMID: 35944119 (Publication Type: Journal Article)
• Copyright: Copyright: © 2022 Permanyer.

Chemical References

• Enbucrilate

Topics

• Aged
• Enbucrilate (adverse effects, therapeutic use)
• Esophageal and Gastric Varices (etiology, therapy)
• Female
• Gastrointestinal Hemorrhage (etiology, therapy)
• Humans
• Middle Aged
• Prospective Studies
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Ultrasonography, Interventional