TY - JOUR T1 - Acrylate glue injection for acutely bleeding oesophageal varices: A prospective cohort study. AU - Cipolletta,L, AU - Zambelli,A, AU - Bianco,M A, AU - De Grazia,F, AU - Meucci,C, AU - Lupinacci,G, AU - Salerno,R, AU - Piscopo,R, AU - Marmo,R, AU - Orsini,L, AU - Rotondano,G, Y1 - 2009/04/11/ PY - 2008/11/14/received PY - 2008/12/14/revised PY - 2009/02/10/accepted PY - 2009/4/14/entrez PY - 2009/4/14/pubmed PY - 2009/12/16/medline SP - 729 EP - 34 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 41 IS - 10 N2 - BACKGROUND: Acrylate glue injection is seldom performed in patients with bleeding oesophageal varices. AIM: To assess efficacy and safety of acrylate glue injection in patients with bleeding oesophageal varices, as well as the impact of this technique on subsequent variceal ligation. METHODS: Prospective study on 133 consecutive cirrhotic patients treated by intravariceal injection of undiluted N-butyl-2-cyanoacrylate into the bleeding varix. Outcome measures were initial haemostasis, recurrent bleeding, complications and mortality at 6 weeks. RESULTS: 52 patients were actively bleeding at endoscopy and 81 showed stigmata of recent haemorrhage. Initial haemostasis was achieved in 49/52 active bleeders (94.2% [95% CI 85.1-98.5]). Overall, early recurrent bleeding occurred in 7 patients (5.2% [95% CI 2.3-10.1]). No major procedure-related complication was recorded. At 6 weeks, death occurred in 11 patients, with an overall bleeding-related mortality of 8.2% [95% CI 5.8-15.3]. Mortality was higher in active (15.4% [95% CI 6.9-28.1]) than non-active bleeders (3.7% [95% CI 0.8-10.4], OR 4.7 [95% CI 1.05-28.7], p=0.02). Of those surviving the first bleeding episode, 112 patients subsequently underwent ligation. No technical difficulties were encountered in performing the banding procedure which was successfully completed in all cases. CONCLUSIONS: Emergency injection of acrylate glue is safe and effective for the treatment of acute bleeding oesophageal varices and does not hamper subsequent variceal ligation. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/19362522/Acrylate_glue_injection_for_acutely_bleeding_oesophageal_varices:_A_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(09)00050-4 DB - PRIME DP - Unbound Medicine ER -