Tags

Type your tag names separated by a space and hit enter

Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety.
Gastrointest Endosc. 2000 Aug; 52(2):160-7.GE

Abstract

BACKGROUND

The long-term efficacy and safety of the endoscopic injection of N-butyl-2-cyanoacrylate (Histoacryl) were evaluated to define its role as the initial treatment for bleeding gastric varices.

METHODS

Ninety patients with bleeding gastric varices underwent endoscopic injections of Histoacryl for hemostasis within a 6-year period. Histoacryl was injected intravariceally as a 1:1 mixture with Lipiodol. Among the 90 patients, 5 had active bleeding and 85 had recent bleeding. Most of the varices were large (F2 or F3, 85 cases). The most common locations were the fundus and the posterior wall of the proximal body (94.4%). After Histoacryl injection, patients were followed endoscopically with retreatment as necessary.

RESULTS

The rate of hemostasis at 1 week was 94.4%. Recurrent bleeding occurred in 23.3% of the patients from 3 days to 16 months after the initial injection. Recurrent bleeding was stopped with reinjections of Histoacryl in 16.7% of the patients. The rate of definitive hemostasis was 93.3% (84 of 90). The treatment failure-related mortality rate was 2.2% (2 of 90). To date, 35 patients have died, mostly as a result of malignancy or liver failure, and 55 are still alive. The determining factor for long-term survival was the underlying disease leading to portal hypertension. There were few long-term complications except for Histoacryl cast extrusion-related mucosal defects.

CONCLUSIONS

Endoscopic injection of Histoacryl is highly effective for the treatment of bleeding gastric varices, with rare complications both acutely and long term. This treatment modality is appropriate as the first choice for bleeding gastric varices.

Authors+Show Affiliations

Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, and National Yang-Ming University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10922085

Citation

Huang, Y H., et al. "Endoscopic Treatment of Bleeding Gastric Varices By N-butyl-2-cyanoacrylate (Histoacryl) Injection: Long-term Efficacy and Safety." Gastrointestinal Endoscopy, vol. 52, no. 2, 2000, pp. 160-7.
Huang YH, Yeh HZ, Chen GH, et al. Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety. Gastrointest Endosc. 2000;52(2):160-7.
Huang, Y. H., Yeh, H. Z., Chen, G. H., Chang, C. S., Wu, C. Y., Poon, S. K., Lien, H. C., & Yang, S. S. (2000). Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety. Gastrointestinal Endoscopy, 52(2), 160-7.
Huang YH, et al. Endoscopic Treatment of Bleeding Gastric Varices By N-butyl-2-cyanoacrylate (Histoacryl) Injection: Long-term Efficacy and Safety. Gastrointest Endosc. 2000;52(2):160-7. PubMed PMID: 10922085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety. AU - Huang,Y H, AU - Yeh,H Z, AU - Chen,G H, AU - Chang,C S, AU - Wu,C Y, AU - Poon,S K, AU - Lien,H C, AU - Yang,S S, PY - 2000/8/2/pubmed PY - 2000/9/30/medline PY - 2000/8/2/entrez SP - 160 EP - 7 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 52 IS - 2 N2 - BACKGROUND: The long-term efficacy and safety of the endoscopic injection of N-butyl-2-cyanoacrylate (Histoacryl) were evaluated to define its role as the initial treatment for bleeding gastric varices. METHODS: Ninety patients with bleeding gastric varices underwent endoscopic injections of Histoacryl for hemostasis within a 6-year period. Histoacryl was injected intravariceally as a 1:1 mixture with Lipiodol. Among the 90 patients, 5 had active bleeding and 85 had recent bleeding. Most of the varices were large (F2 or F3, 85 cases). The most common locations were the fundus and the posterior wall of the proximal body (94.4%). After Histoacryl injection, patients were followed endoscopically with retreatment as necessary. RESULTS: The rate of hemostasis at 1 week was 94.4%. Recurrent bleeding occurred in 23.3% of the patients from 3 days to 16 months after the initial injection. Recurrent bleeding was stopped with reinjections of Histoacryl in 16.7% of the patients. The rate of definitive hemostasis was 93.3% (84 of 90). The treatment failure-related mortality rate was 2.2% (2 of 90). To date, 35 patients have died, mostly as a result of malignancy or liver failure, and 55 are still alive. The determining factor for long-term survival was the underlying disease leading to portal hypertension. There were few long-term complications except for Histoacryl cast extrusion-related mucosal defects. CONCLUSIONS: Endoscopic injection of Histoacryl is highly effective for the treatment of bleeding gastric varices, with rare complications both acutely and long term. This treatment modality is appropriate as the first choice for bleeding gastric varices. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/10922085/Endoscopic_treatment_of_bleeding_gastric_varices_by_N_butyl_2_cyanoacrylate__Histoacryl__injection:_long_term_efficacy_and_safety_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(00)02407-X DB - PRIME DP - Unbound Medicine ER -