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DOI: 10.1055/s-0045-1806741
Endoscopic Cyanoacrylate Injection in the Management of Gastric Varices: Long-Term Safety and Efficacy
Authors
Funding None declared.
Abstract
Introduction
Despite endoscopic ultrasound-based endotherapy and radiologic intervention, endoscopic cyanoacrylate (E-CYA) injection still remain as commonly performed treatment modality for bleeding gastric varices (GVs) in real world. We analyzed the long-term safety and efficacy of E-CYA in bleeding GVs.
Patients and Methods
In this retrospective analysis, patients who underwent E-CYA for GVs over the past 10 years were analyzed. The technical success, hemostasis rate, rebleeding rate, mortality rate, and procedure-related complications were analyzed. The predictive factors for a rebleed in terms of Child–Pugh status, the type, form, and size of GVs were computed.
Results
Of the 113, 96 (84.9%) met the inclusion criteria. The median follow-up was 30 (12–49) months. The mean age was 48.1 ± 6.1 years with most being male (83.3%, n = 80). The majority of them had cirrhosis (85.4%, n = 82). The technical success to achieve primary hemostasis was 98.9%. The median volume of glue to achieve hemostasis for each session was 2 (2–4) mL. At 1 month, 12 patients had a clinically significant rebleed (12.5%) and 6 (6.3%) had a rebleed at 6 months. At 1 and 6 months, 68.75% did not require further glue injection. The disease-related mortality was 10.41%. There was no procedure-related mortality.
Conclusion
E-CYA injection shows excellent efficacy and long-term safety with low rebleeding rates and negligible procedure-related complications.
Ethical Approval and Consent to Participate
Taken from institutional ethical committee.
Consent for Publication
Sought from the patient.
Availability of Supporting Data
Available from G.B. upon reasonable request.
Authors' Contributions
A.K. and S.N.: Preparing the primary draft of the manuscript. P.K., A.S., and B.M.: Data collection. G.P.C., G.B., and S.S.: Review of the manuscript. S.R.: Statistical analysis.
Publikationsverlauf
Artikel online veröffentlicht:
17. März 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
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