Endoscopic treatment of bleeding gastric varices with histoacryl (N-butyl-2-cyanoacrylate): a South European single center experience

Background Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safet...

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Bibliographic Details
Published in:Indian journal of gastroenterology 2013-07, Vol.32 (4), p.227-231
Main Authors: Monsanto, Pedro, Almeida, Nuno, Rosa, Albano, Maçôas, Fernanda, Lérias, Clotilde, Portela, Francisco, Amaro, Pedro, Ferreira, Manuela, Gouveia, Hermano, Sofia, Carlos
Format: Article
Language:English
Subjects:
Enbucrilate - administration & dosage
Endoscopy, Gastrointestinal - methods
Esophageal and Gastric Varices - therapy
Female
Follow-Up Studies
Gastroenterology
Gastrointestinal Hemorrhage - therapy
Hemostasis, Endoscopic - methods
Hepatology
Humans
Injections
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Retrospective Studies
Sclerotherapy - methods
Treatment Outcome
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Summary:Background Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safety of cyanoacrylate in patients with gastric variceal bleeding. Patients and Methods Between January 1998 and January 2010, 97 patients with gastric variceal bleeding underwent endoscopic treatment with a mixture of N-butyl-2-cyanoacrylate and Lipiodol TM . Ninety-one patients had cirrhosis and 6 had non-cirrhotic portal hypertension. Child-Pugh score at presentation for cirrhotic patients was A–12.1 %; B–53.8 %; C–34.1 % and median MELD score at admission was 13 (3–26). Successful hemostasis, rebleeding rate and complications were reviewed. Median time of follow up was 19 months (0.5–126). Results A median mixture volume of 1.5 mL (0.6 to 5 mL), in 1 to 8 injections, was used, with immediate hemostasis rate of 95.9 % and early rebleeding rate of 14.4 %. One or more complications occurred in 17.5 % and were associated with the use of Sengstaken-Blakemore tube before cyanoacrylate and very early rebleeding ( p  
ISSN:0254-8860
0975-0711
DOI:10.1007/s12664-012-0191-3