Document Detail

Endoscopic management of gastric variceal bleeding with cyanoacrylate glue injection: safety and efficacy in a Canadian population.
MedLine Citation:
PMID:  21037987     Owner:  NLM     Status:  MEDLINE    
BACKGROUND:  Gastric variceal bleeding (GVB) is a major cause of morbidity and mortality among patients with portal hypertension. Endoscopic band ligation and standard sclerotherapy have been used but have significant limitations. Decompression through transjugular intrahepatic portosystemic shunt insertion has been shown to be effective. Gastric variceal injection therapy with a commercially available cyanoacrylate glue is less invasive than transjugular intrahepatic portosystemic shunt insertion and has recently been shown to be effective for acute hemostasis. 
OBJECTIVE: To assess the immediate and long-term outcomes of cyanoacrylate glue injection therapy for GVB.
METHODS: A retrospective chart review was conducted to identify patients treated with cyanoacrylate injection for GVB at two tertiary care hospitals over a period of six years. The outcomes assessed included complications, acute hemostasis, rebleeding rate and all-cause mortality.
RESULTS: Thirty-seven patients (60% men) underwent cyanoacrylate glue injections for GVB. The median follow-up period was 14 months and included 29 patients (eight were lost to follow-up). Initial hemostasis was achieved in 35 patients (95%). No significant complications from cyanoacrylate injection were observed. Early rebleeding was rare (8%) and late rebleeding occurred in only 28% of patients. The all-cause mortality rate was 28.6% during the median follow-up period. 
CONCLUSION: The data suggest that cyanoacrylate injection therapy is safe and effective for the prevention of short- and long-term bleeding from gastric varices. Furthermore, although these patients had significant comorbid disease, survival in the follow-up time period was greater than 70%.
Jaber Al-Ali; Monika Pawlowska; Alan Coss; Sigrid Svarta; Michael Byrne; Robert Enns
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  24     ISSN:  0835-7900     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2011-02-17     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  593-6     Citation Subset:  IM    
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MeSH Terms
Cohort Studies
Enbucrilate / administration & dosage*
Endoscopy, Gastrointestinal*
Esophageal and Gastric Varices / complications,  pathology,  therapy*
Gastrointestinal Hemorrhage / etiology,  pathology,  therapy*
Hemostasis, Endoscopic*
Middle Aged
Retrospective Studies
Treatment Outcome
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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