Band ligation vs. N-Butyl-2-cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow-up study

Tanţău, Marcel; Crişan, Dana; Popa, Daniel; Vesa, Ștefan Cristian; Tanțău, Alina

doi:10.1016/s1665-2681(19)30907-x

Cited by 42 publications

(47 citation statements)

References 30 publications

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“…In our study, hemostatic control was achieved in 100% of CYA sclerosis caused by emergency bleeding. Previous studies such as Tantau et al [12] and Serón P [13] have shown that cyanoacrylate is not inferior to treatment with ligation of varicose veins and its results are equivalent to the use of TIPS (Transjugular intrahepatic portosystemic shunt) as shown in the study by Procaccini et al [14] , without the presence of technical problems such as development of portal vein thrombosis, and encephalopathy described with the use of TIPS (Transjugular intrahepatic portosystemic shunt). The advantages of cyanoacrylate sclerotherapy include direct bleeding control and evaluation, increased reliability, reduced equipment requirements, use of conventional supplies such as standard sclerotherapy needles, rapid bleeding control, and low probability of endoscope damage using the appropriate technique.…”

Section: Discussionmentioning

confidence: 86%

Sclerosis of Fundic Varices. Experience in a Reference Center in the South West of Colombia, 2011-2017

Maldonado

2019

Journal of Gastroenterology and Hepatology Research

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for this type of patients. This study was carried out to make known the demographic characteristics of patients with gastric varices with or without the presence of esophageal varices that were taken to cyanocrylate sclerotherapy (CYP). Endoscopic findings, outcomes and complications are described. Data used to evaluate the safety and efficacy of the procedure in the management of patients with or without active variceal bleeding. This observational descriptive retrospective cross-sectional study included patients with manifest portal hypertension with esophageal and fundic varices, a total of 132 sclerotherapy procedures with cyanoacrylate mixed with lipiodol. We included 132 records of sclerotherapy with CYA, with equal gender distribution. Esophageal varices were found in 90.2% (119 records). In 31 procedures the indication was emergency bleeding (23.5%), of these 7 had CP-A, 12 CP-B, 0 CP-C and 12 without data. Out of the 101 elective interventions, 34 had CP-A, 24 CP-B, 6 CP-C and 37 without data, with no significant differences between groups (p value = 0.1). Homeostasis was achieved in 100% of patients with active bleeding. Varice sclerosis was successful with a single puncture in 81.1%, two punctures in 13.6% and three or more in 5.3% of the procedures. There were no complications in any of the patients, nor damage in the equipment used. In conclusión Endoscopic obliteration of fundic varices with CYP was safe and effective in the treatment of upper gastric variceal bleeding, without clinical complications in the procedure or damage to the endoscopic equipment used.

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Section: Discussionmentioning

confidence: 86%

Sclerosis of Fundic Varices. Experience in a Reference Center in the South West of Colombia, 2011-2017

Maldonado

2019

Journal of Gastroenterology and Hepatology Research

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“…There was one prospective study [17] and two retrospective studies [15, 16], and all three were of high quality (Newcastle-Ottawa scale score ≥ 6).…”

Section: Resultsmentioning

confidence: 99%

Cyanoacrylate Injection Compared with Band Ligation for Acute Gastric Variceal Hemorrhage: A Meta-Analysis of Randomized Controlled Trials and Observational Studies

Huai

Chen

2014

Gastroenterology Research and Practice

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Background. Cyanoacrylate injection (GVO) and band ligation (GVL) are effective treatments for gastric variceal hemorrhage. However, data on the optimal treatment are still controversial. Methods. For our overall analysis, relevant studies were identified from several databases. For each outcome, data were pooled using a fixed-effect or random-effects model according to the result of a heterogeneity test. Results. Seven studies were included. Compared with GVL, GVO was associated with increased likelihood of hemostasis of active bleeding (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.19–4.51) and a longer gastric variceal rebleeding-free period (hazard ratio = 0.37; 95% CI = 0.24–0.56). No significant differences were observed between GVL and GVO for mortality (hazard ratio = 0.66; 95% CI = 0.43–1.02), likelihood of variceal obliteration (OR = 0.89; 95% CI = 0.52–1.54), number of treatment sessions required for complete variceal eradication (weighted mean difference = −0.45; 95% CI = −1.14–0.23), or complications (OR = 1.02; 95% CI = 0.48–2.19). Conclusion. GVO may be superior to GVL for achieving hemostasis and preventing recurrence of gastric variceal rebleeding but has no advantage over GVL for mortality and complications. Additional studies are warranted to enable definitive conclusions.

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“…Injection‐based therapies have included sclerosants (such as alcohol), fibrin glue, thrombin, cyanoacrylate glues and coils. However, cyanoacrylate injection has become the treatment of choice given the relatively high re‐bleeding and recurrence rates of other modalities . With traditional EGD, cyanoacrylate can be delivered via a freehand injection technique under direct visualization of fundal or isolated gastric varices.…”

Section: Eus and Gastric Varicesmentioning

confidence: 99%

Endoscopic ultrasound and the liver: current applications and beyond

Shah

Baron

2018

J Hepato Biliary Pancreat

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The diagnosis and management of many gastrointestinal conditions has been augmented by the development of endoscopic ultrasound. Its role in the diagnosis and management of liver disease has been somewhat limited, but with the rapid development of therapeutic advancements it has quickly emerged as a useful tool in the management of complex hepatic conditions. This includes its use in the management of complications of portal hypertension as well as its use in liver lesions and cancer. In this paper, we review case studies, case series and trials for hepatic applications of endoscopic ultrasound to provide an overview of its utilization in this field and demonstrating its more novel applications for future use.

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Band ligation vs. N-Butyl-2-cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow-up study

Cited by 42 publications

References 30 publications

Sclerosis of Fundic Varices. Experience in a Reference Center in the South West of Colombia, 2011-2017

Sclerosis of Fundic Varices. Experience in a Reference Center in the South West of Colombia, 2011-2017

Cyanoacrylate Injection Compared with Band Ligation for Acute Gastric Variceal Hemorrhage: A Meta-Analysis of Randomized Controlled Trials and Observational Studies

Endoscopic ultrasound and the liver: current applications and beyond

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