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Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices.
Dig Dis. 2008; 26(4):300-3.DD

Abstract

BACKGROUND

Bleeding gastric varices (BGV) are a severe complication of portal hypertension. Although the obliteration of gastric varices using cyanoacrylate has been shown effective to eradicate gastric varices, there are still few data available on its effectiveness for acutely BGV, cyanoacrylate-related complications and follow-up.

AIMS

To report on the feasibility, efficacy and outcomes of N-buytl-2-cyanoacrylate sclerotherapy in patients with BGV.

METHODS

This is a retrospective cohort study of consecutive patients who were evaluated for BGV at University of Magdeburg Medical Center. Data abstracted for analysis from the prospectively collected database included patient's demographics, etiology of gastric varices, Child-Pugh score, effectiveness of endoscopic treatment, clinical and endoscopic follow-up. Immediate hemostasis was defined as visible and clinical arrest of bleeding. The following were considered as potential complications of the procedure: aspiration, fever, worsening hemorrhage due to the sclerotherapy and systemic embolization of cyanoacrylate.

RESULTS

33 patients (17 F, 16 M; mean age 54 years, range 18-81) with BGV (29 had active bleeding and 4 had stigmata of recent bleeding) underwent endoscopic injections of N-butyl-2-cyanoacrylate for hemostasis over a 5-year period. Mean follow-up: 9 months (range: 1 month to 5 years). Initial hemostasis was achieved in 88%. Treatment-related complications occurred in 5 (15.1%), the most common being deep ulcerations, which also resulted in recurrent bleeding. One patient presented with distal cyanoacrylate embolization. During long-term follow-up, 6 patients died, 5 as a consequence of the underlying liver disease and 1 as a consequence of complications due to systemic cyanoacrylate embolization.

CONCLUSIONS

N-butyl-2-cyanoacrylate sclerotherapy is highly effective for the treatment of BGV, with rare complications occurring both acutely and in the long term.

Authors+Show Affiliations

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19188718

Citation

Fry, Lucía C., et al. "Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy With N-butyl-2-cyanoacrylate for Bleeding Gastric Varices." Digestive Diseases (Basel, Switzerland), vol. 26, no. 4, 2008, pp. 300-3.
Fry LC, Neumann H, Olano C, et al. Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices. Dig Dis. 2008;26(4):300-3.
Fry, L. C., Neumann, H., Olano, C., Malfertheiner, P., & Mönkemüller, K. (2008). Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices. Digestive Diseases (Basel, Switzerland), 26(4), 300-3. https://doi.org/10.1159/000177012
Fry LC, et al. Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy With N-butyl-2-cyanoacrylate for Bleeding Gastric Varices. Dig Dis. 2008;26(4):300-3. PubMed PMID: 19188718.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices. AU - Fry,Lucía C, AU - Neumann,Helmut, AU - Olano,Carolina, AU - Malfertheiner,Peter, AU - Mönkemüller,Klaus, Y1 - 2009/01/30/ PY - 2009/2/4/entrez PY - 2009/2/4/pubmed PY - 2009/2/25/medline SP - 300 EP - 3 JF - Digestive diseases (Basel, Switzerland) JO - Dig Dis VL - 26 IS - 4 N2 - BACKGROUND: Bleeding gastric varices (BGV) are a severe complication of portal hypertension. Although the obliteration of gastric varices using cyanoacrylate has been shown effective to eradicate gastric varices, there are still few data available on its effectiveness for acutely BGV, cyanoacrylate-related complications and follow-up. AIMS: To report on the feasibility, efficacy and outcomes of N-buytl-2-cyanoacrylate sclerotherapy in patients with BGV. METHODS: This is a retrospective cohort study of consecutive patients who were evaluated for BGV at University of Magdeburg Medical Center. Data abstracted for analysis from the prospectively collected database included patient's demographics, etiology of gastric varices, Child-Pugh score, effectiveness of endoscopic treatment, clinical and endoscopic follow-up. Immediate hemostasis was defined as visible and clinical arrest of bleeding. The following were considered as potential complications of the procedure: aspiration, fever, worsening hemorrhage due to the sclerotherapy and systemic embolization of cyanoacrylate. RESULTS: 33 patients (17 F, 16 M; mean age 54 years, range 18-81) with BGV (29 had active bleeding and 4 had stigmata of recent bleeding) underwent endoscopic injections of N-butyl-2-cyanoacrylate for hemostasis over a 5-year period. Mean follow-up: 9 months (range: 1 month to 5 years). Initial hemostasis was achieved in 88%. Treatment-related complications occurred in 5 (15.1%), the most common being deep ulcerations, which also resulted in recurrent bleeding. One patient presented with distal cyanoacrylate embolization. During long-term follow-up, 6 patients died, 5 as a consequence of the underlying liver disease and 1 as a consequence of complications due to systemic cyanoacrylate embolization. CONCLUSIONS: N-butyl-2-cyanoacrylate sclerotherapy is highly effective for the treatment of BGV, with rare complications occurring both acutely and in the long term. SN - 1421-9875 UR - https://www.unboundmedicine.com/medline/citation/19188718/Efficacy_complications_and_clinical_outcomes_of_endoscopic_sclerotherapy_with_N_butyl_2_cyanoacrylate_for_bleeding_gastric_varices_ L2 - https://www.karger.com?DOI=10.1159/000177012 DB - PRIME DP - Unbound Medicine ER -