Endoscopic injection of cyanoacrylate glue versus other endoscopic procedures for acute bleeding gastric varices in people with portal hypertension

Castellanos, Eddy Ríos; Serón, Pamela; Gisbert, Javier P.; Cosp, Xavier Bonfill

doi:10.1002/14651858.cd010180.pub2

Cited by 76 publications

(75 citation statements)

References 79 publications

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“…[51][52][53] ECI has been shown to be effective at preventing both early and late rebleeding, with fewer complications compared with alcohol-based sclerotherapy or band ligation. 41,42,[53][54][55] Unfortunately, studies comparing endoscopic interventions for GVs have not consistently segregated different classifications of GVs when Fig. 2 Vascular anatomy of gastric varices.…”

Section: Definitive Therapy Of Bleeding From Gastric and Ectopic Varimentioning

confidence: 99%

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

Henry

2020

Digestive Disease Interventions

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Gastric and Ectopic varices are a rare complication of portal hypertension and represent a complex, heterogeneous system of vascular shunts. Bleeding from these shunts can be severe and life-threatening, with poorly standardized treatment algorithms to follow in their management. When bleeding occurs, it is important to follow standard diagnostic procedures for portal hypertensive bleeding and always obtain imaging of the underlying vascular anatomy to help guide therapy. Potential treatment methods will depend on these imaging findings as well as the location of the varix within the gastrointestinal tract. While gastric varices have more data to support specific treatment options, duodenal and rectal varices have only case reports and case series to guide their care. In addition, stomal varices are a very rare complication of portal hypertension and have limited data to support any one treatment modality. Gastric and ectopic varices are best approached in a multidisciplinary fashion after discussion with hepatologists and interventional radiologists to overcome the uncertainty in choosing a definitive therapy.

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Section: Definitive Therapy Of Bleeding From Gastric and Ectopic Varimentioning

confidence: 99%

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

Henry

2020

Digestive Disease Interventions

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“…A meta-analysis comparing cyanoacrylate injection versus EVL in endoscopic therapy of gastric VH (primarily GOV1 varices) shows that both therapies are equally effective for initial hemostasis, but cyanoacrylate injection is associated with a significantly lower rebleeding rate. 47 As such, current recommendations for the treatment of actively bleeding GOV1 are for either EVL (if technically feasible) or cyanoacrylate glue injection. 13 TIPS is very effective in the treatment of bleeding GV, with more than 90% success rate for initial hemostasis, 48 and is the preferred treatment for the control of bleeding from GOV2 or IGV1.…”

Section: Gastric Varicesmentioning

confidence: 99%

Clinical Assessment and Management of Portal Hypertension

Kibrit

Khan

Jung

et al. 2018

Semin intervent Radiol

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The development of portal hypertension in a patient with cirrhosis portends a poor prognosis. Untreated or progressive portal hypertension has serious clinical outcomes, which are often fatal. It is important to recognize portal hypertension early to delay progression and to treat complications of portal hypertension as they arise. This review will focus on the clinical assessment and management of portal hypertension.

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“…38 Cyanoacrylate and thrombin Cyanoacrylate, also known as 'glue', is a strong adhesive with multiple industrial and domestic applications. For type 2 gastro-oesophageal varices (GOV-2) and isolated gastric varices (IGV), cyanoacrylate has been shown to be superior to VBL in achieving haemostasis and reducing rebleeding, 39,40 and has been approved by NICE and BSG. 6 Recently, thrombin injection has been accepted as an alternative to cyanoacrylate for gastric varices, 18 with haemostasis rates of 94% and rebleeding rates of 18%.…”

Section: Variceal Band Ligation (Vbl)mentioning

confidence: 99%

Management of Acute Upper Gastrointestinal Bleeding: An Update for the General Physician

Siau

Chapman

Sharma

et al. 2017

Journal of the Royal College of Physicians of Edinburgh

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Acute upper gastrointestinal bleed (AUGIB) is one of the most common medical emergencies in the UK, with roughly one presentation every 6 min. Despite advances in therapeutics and endoscopy provision, mortality following AUGIB over the last two decades has remained high, with over 9,000 deaths annually in the UK; consequently, several national bodies have published UKrelevant guidelines. Despite this, the 2015 UK National Con dential Enquiry into Patient Outcome and Death in AUGIB highlighted variations in practice, raised concerns regarding suboptimal patient care and released a series of recommendations. This review paper incorporates the latest available evidence and UK-relevant guidelines to summarise the optimal pre-endoscopic, endoscopic, and post-endoscopic approach to and management of non-variceal and variceal AUGIB that will be of practical value to both general physicians and gastroenterologists.

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Endoscopic injection of cyanoacrylate glue versus other endoscopic procedures for acute bleeding gastric varices in people with portal hypertension

Cited by 76 publications

References 79 publications

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

Clinical Assessment and Management of Portal Hypertension

Management of Acute Upper Gastrointestinal Bleeding: An Update for the General Physician

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