Clinical evaluation of endoscopic injection sclerotherapy using n‐butyl‐2‐cyanoacrylate for gastric variceal bleeding

Abstract

Based on these results, the Histoacryl method is thought to be the initial treatment of choice for gastric variceal bleeding, because it achieved superior haemostasis compared with EO and death by haemorrhage was avoided.

Percutaneous transhepatic obliteration for massive variceal rectal bleeding

“…Embolized Lipiodol may also produce lung damage such as that caused by chemical injury, resulting from the breakdown of the embolized Lipiodol into free fatty acids [13]. The amount of NBCA mixture generally used during endoscopic sclerotherapy is limited to be less than 3 ml to prevent occlusion of undesired vessels or inadvertent embolism [14], and in our cases, the total of the NBCA mixture was less than 3 ml on both cases. Endoscopic treatment and/or TIPS have been developed for common types of varices, but we believe that PTO still has a role in the emergent treatment of special types of bleeding varices, but additional treatment for the reduction of the portal venous hypertension might be needed as an elective procedure.…”

Anticoagulation in the treatment of portovenous emboli after cyanoacrylate injection for a bleeding gastric varix

“…(3) Cyanoacrylate is an adhesive that polymerises on contact with tissue moisture to form a firm, stable mass within the varix. In the largest series (635 patients over 10 years) reported by Cheng et al, (4) endoscopic injection of cyanoacrylate had a 95% success rate of achieving initial haemostasis and has emerged in many centres worldwide as the initial treatment of choice for acute bleeding gastric varices.…”

Hepatic failure requiring transplantation caused by portal vein embolism as a complication of N-buty-2-cyanoacrylate injection for a bleeding gastric varix

“…1 Gastric variceal bleeding has a higher recurrence rate than bleeding from esophageal varices, and the 1-year mortality rate was reported to be 52%. 2 The blood to most gastric varices is supplied from the short gastric and epiploic veins, which drain to the left renal vein via a large gastrorenal shunt. 3 The lung is the most common site of systemic embolization from portal circulation.…”

“…1 Endoscopic injection of Histoacryl (B. Braun Corp, Melsungen, Germany) can control bleeding in more than 80% of cases and has been proven to be an excellent treatment for gastric variceal bleeding. [1][2][3] However, it has the risk of complications such as systemic [4][5][6] or portal system embolization, [7][8][9][10] retrogastric abscess, 11 and fistula formation. 12 Herein we report a case of hepatic failure requiring transplantation caused by portal vein embolism after endoscopic injection of Histoacryl.…”