Randomized, controlled study of various agents for endoscopic injection sclerotherapy of bleeding canine gastric varices

Jutabha, Rome; Jensen, Dennis M.; See, Jacques; Machicado, Gustavo A.; Hirabayashi, Kenneth

doi:10.1016/s0016-5107(95)70339-x

Cited by 22 publications

(12 citation statements)

References 26 publications

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“…More recent studies have shown similar results [19,20]. A randomized, controlled study of various sclerotherapy agents conducted in canines showed that cyanoacrylate was superior to sodium tetradecyl sulfate, ethanol, sodium morrhuate, polidocanol, and epinephrine in terms of immediate efficacy, low-volume requirement, time to initial hemostasis, and size reduction of varices [21]. A small, randomized study in humans comparing Histacryl with endoscopic band ligation showed them to be equally effective with rebleeding rates of 12 and 14%, respectively [22].…”

Section: Gastric Varicesmentioning

confidence: 75%

Extraesophageal Varices

Kotfila¹,

Trudeau²

1998

Dig Dis

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Esophageal varices are the most common site of variceal bleeding. However, bleeding from varices that are not located in the esophagus may account for up to 30% of all variceal bleeding. Significant varices can occur in the stomach, duodenum, jejunum, ileum, colon, rectum, and biliary tree. They can also occur at the site of a surgical ostomy. These types of varices bleed less commonly than esophageal varices, but they can also be far more difficult to diagnose and treat. The absence of stigmata of recent esophageal variceal bleeding and certain clues in the patient’s history and clinical presentation should raise the clinician’s suspicion of an extraesophageal site of variceal bleeding. Particularly, patients with extrahepatic causes of portal hypertension, cirrhotic patients with a prior history of gastrointestinal surgery, and patients who present with profound bleeding but without hematemesis need to be evaluated further if an obvious site of esophageal variceal bleeding is not seen on initial endoscopy. In this article, we review the features particular to extraesophageal varices as well as the diagnosis and management of bleeding from these varices. We use the term extraesophageal rather than ectopic because the term ectopic varices implies exclusion of both esophageal and gastric varices.

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Section: Gastric Varicesmentioning

confidence: 75%

Extraesophageal Varices

Kotfila¹,

Trudeau²

1998

Dig Dis

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“…EIS has been less successful in the treatment of bleeding from FVs, however. When used with 1% polidocanol, 5% ethanolamine oleate iopamidol (EOI), or thrombin for this purpose, EIS has a high rate of operative mortality [27][28][29] . Fortunately, the rate of initial hemostasis has been significantly improved since the introduction of N-butyl-2-cyanoacrylate (Histoacryl) as the sclerosant in EIS [30,31] .…”

Section: Endoscopic Treatmentmentioning

confidence: 99%

New methods for the management of gastric varices

Yoshida¹

2006

WJG

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Bleeding from gastric varices has been successfully treated by endoscopic modalities. Once the bleeding from the gastric varices is stabilized, endoscopic treatment and/or interventional radiology should be performed to eradicate varices completely. Partial splenic artery embolization is a supplemental treatment to prolong the obliteration of the veins feeding and/or draining the varices. The overall incidence of bleeding from gastric varices is lower than that from esophageal varices. No studies to date have definitively characterized the causal factors behind bleeding from gastric varices. The initial episodes of bleeding from esophageal varices or gastric varices without prior treatment may be at least partly triggered by a violation of the mucosal barrier overlying varices. This is especially likely in the case of varices of the fundus. In view of the high rate of hemostasis achieved among bleeding gastric varices, treatment should be administered in selective cases. Among untreated cases, steps to prevent gastric mucosal injury confer very important protection against gastric variceal bleeding.

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“…This procedure led to a significant increase of mean pre-and postshunt portal pressure, from 12 G 0.4 to 23 G 1 cm saline, and the development of large gastric varices caused by increased blood flow from the subhepatic inferior vena cava and the portal vein to the right atrium through collaterals. For the first time, this animal model allowed the simulation of endoscopic hemostasis of an acute upper GI variceal bleed in a live animal [24][25][26][27][28][29].…”

Section: In Vivo Models Of Upper Gastrointestinal Hemorrhagementioning

confidence: 99%

Simulator Training in Endoscopic Hemostasis

Matthes

2006

Gastrointestinal Endoscopy Clinics of North America

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Randomized, controlled study of various agents for endoscopic injection sclerotherapy of bleeding canine gastric varices

Cited by 22 publications

References 26 publications

Extraesophageal Varices

Extraesophageal Varices

New methods for the management of gastric varices

Simulator Training in Endoscopic Hemostasis

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