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Cyanoacrylate glue in the management of gastric varices.
Minerva Med. 2009 Feb; 100(1):115-21.MM

Abstract

Gastric varices (GV) are less common than esophageal varices, but their management represents a particular challenge. When bleeding occurs is usually severe, requiring immediate supportive intensive care and has a high mortality rate. The best management of GV is supposed to be with a multidisciplinary approach and close cooperation between gastroenterologists, interventional radiologists and the surgical team. Many studies in literature reported high success rates with intravariceal injection of cyanoacrylate in acute GV bleeding. This agent obliterates the variceal lumen by solidification within the vein and more than 80% primary obliteration rates are achieved. In comparison with other endoscopic techniques as variceal band ligation or sclerotherapy with ethanolamine oleate, alcohol and sodium tetradecyl sulphate, cyanoacrylate has shown to be more effective, with a decrease in complications and mortality rates. The cyanoacrylate has shown effective also in the secondary prophylaxis with an incidence of re-bleeding that ranges between 15% and 30%. Actually, there is no scientific evidence supporting the application of cyanoacrylate in primary prophylaxis of bleeding from GV. Significant procedural, septic and embolic complications have been reported with cyanoacrylate glue injection. In conclusion, the endoscopic treatment with cyanoacrylate of actively bleeding GV, as well as the prophylaxis of the re-bleeding, is a safe and effective procedure and should be considered as a first-line therapy, whenever available.

Authors+Show Affiliations

Department of Medicine, University Hospital G. Martino, Messina, Italy. carmeluigiano@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19078888

Citation

Consolo, P, et al. "Cyanoacrylate Glue in the Management of Gastric Varices." Minerva Medica, vol. 100, no. 1, 2009, pp. 115-21.
Consolo P, Luigiano C, Giacobbe G, et al. Cyanoacrylate glue in the management of gastric varices. Minerva Med. 2009;100(1):115-21.
Consolo, P., Luigiano, C., Giacobbe, G., Scaffidi, M. G., Pellicano, R., & Familiari, L. (2009). Cyanoacrylate glue in the management of gastric varices. Minerva Medica, 100(1), 115-21.
Consolo P, et al. Cyanoacrylate Glue in the Management of Gastric Varices. Minerva Med. 2009;100(1):115-21. PubMed PMID: 19078888.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cyanoacrylate glue in the management of gastric varices. AU - Consolo,P, AU - Luigiano,C, AU - Giacobbe,G, AU - Scaffidi,M G, AU - Pellicano,R, AU - Familiari,L, Y1 - 2008/12/15/ PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/7/17/medline SP - 115 EP - 21 JF - Minerva medica JO - Minerva Med VL - 100 IS - 1 N2 - Gastric varices (GV) are less common than esophageal varices, but their management represents a particular challenge. When bleeding occurs is usually severe, requiring immediate supportive intensive care and has a high mortality rate. The best management of GV is supposed to be with a multidisciplinary approach and close cooperation between gastroenterologists, interventional radiologists and the surgical team. Many studies in literature reported high success rates with intravariceal injection of cyanoacrylate in acute GV bleeding. This agent obliterates the variceal lumen by solidification within the vein and more than 80% primary obliteration rates are achieved. In comparison with other endoscopic techniques as variceal band ligation or sclerotherapy with ethanolamine oleate, alcohol and sodium tetradecyl sulphate, cyanoacrylate has shown to be more effective, with a decrease in complications and mortality rates. The cyanoacrylate has shown effective also in the secondary prophylaxis with an incidence of re-bleeding that ranges between 15% and 30%. Actually, there is no scientific evidence supporting the application of cyanoacrylate in primary prophylaxis of bleeding from GV. Significant procedural, septic and embolic complications have been reported with cyanoacrylate glue injection. In conclusion, the endoscopic treatment with cyanoacrylate of actively bleeding GV, as well as the prophylaxis of the re-bleeding, is a safe and effective procedure and should be considered as a first-line therapy, whenever available. SN - 0026-4806 UR - https://www.unboundmedicine.com/medline/citation/19078888/Cyanoacrylate_glue_in_the_management_of_gastric_varices_ L2 - http://www.minervamedica.it/index2.t?show=R10Y2009N01A0115 DB - PRIME DP - Unbound Medicine ER -