EUS‐guided coil and glue injection versus endoscopic glue injection for gastric varices: International multicentre propensity‐matched analysis

Background Gastric varices (GVs) are conventionally managed with endoscopic cyanoacrylate (E‐CYA) glue injection. Endoscopic ultrasound (EUS)‐guided therapy using combination of coils and CYA glue (EUS‐CG) is a relatively recent modality. There is limited data comparing the two techniques. Methodolo...

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Bibliographic Details
Published in:Liver international 2023-08, Vol.43 (8), p.1783-1792
Main Authors: Samanta, Jayanta, Nabi, Zaheer, Facciorusso, Antonio, Dhar, Jahnvi, Akbar, Wahid, Das, Aritra, Birda, Chhagan Lal, Mangiavillano, Benedetto, Auriemma, Francesco, Crino, Stefano Francesco, Kochhar, Rakesh, Lakhtakia, Sundeep, Reddy, Duvvur Nageshwar
Format: Article
Language:English
Subjects:
Bleeding
cyanoacrylate
Cyanoacrylates
Endoscopy
Endosonography - methods
endotherapy
Esophageal and Gastric Varices - diagnostic imaging
Esophageal and Gastric Varices - therapy
gastroesophageal varices
gastrointestinal bleeding
Gastrointestinal Hemorrhage - diagnostic imaging
Gastrointestinal Hemorrhage - therapy
Hemostasis, Endoscopic - methods
Humans
Injection
Male
portal hypertension
Regression analysis
Therapy
Treatment Outcome
Ultrasonic imaging
Ultrasound
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Summary:Background Gastric varices (GVs) are conventionally managed with endoscopic cyanoacrylate (E‐CYA) glue injection. Endoscopic ultrasound (EUS)‐guided therapy using combination of coils and CYA glue (EUS‐CG) is a relatively recent modality. There is limited data comparing the two techniques. Methodology This international multicentre study included patients with GV undergoing endotherapy from two Indian and two Italian tertiary care centres. Patients undergoing EUS‐CG were compared with propensity‐matched E‐CYA cases from a cohort of 218 patients. Procedural details such as amount of glue, number of coils used, number of sessions required for obliteration, bleeding after index procedure rates and need for re‐intervention were noted. Results Of 276 patients, 58 (male 42, 72.4%; mean age—44.3 ± 12.1 years) underwent EUS‐CG and were compared with 118 propensity‐matched cases of E‐CYA. In the EUS‐CG arm, complete obliteration at 4 weeks was noted in 54 (93.1%) cases. Compared to the E‐CYA cohort, EUS‐CG arm showed significantly lower number of session (1.0 vs. 1.5; p 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.15630