842 a Randomized Trial of Endoscopic Band Ligation Versus Cyanoacrylate Injection in the Management of Bleeding Junctional Varices

Portal hypertensive bleeding in cirrhosis

“…Meta‐analysis of three RCTs comparing cyanoacrylate injection versus EVL shows that both therapies are equally effective for initial hemostasis, but cyanoacrylate injection is associated with significantly lower rebleeding rates . The overall quality of the evidence is low given small sample sizes, and the meta‐analysis was dominated by the larger study including only GOV1 varices . In addition, EVL should only be performed on small GV in which both the mucosal and contralateral wall of the vessel can be suctioned into the ligator; otherwise, the band will fall off in several days, leaving an ulcer overlying the vessel, which can result in catastrophic rebleeding.…”

Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding

“…41 There have been at least 3 controlled studies comparing EVO to EVBL or EIS with favorable outcomes of EVO in terms of primary hemostasis, rebleeding rates and complications (summarized in Table 2). 42-44 In a recent meta-analysis involving 648 patients with bleeding gastric varices (all types), pooled analysis suggested better efficacy of EVO in achieving primary hemostasis, and lower rebleeding rates (OR 2.32; 95% CI 1.19-4.51). 45 There was no difference between EVO and EVBL in terms of mortality, complications and number of treatment sessions required for complete variceal eradication.…”

“…44,47 Most common ones are transient fever, chest and abdominal pain etc. In studies comparing EVO with EIS or EVBL, the overall complication rates were similar.…”

Balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices

“…Ligation had more complications (primarily treatment‐induced ulcer bleeding) and a strong trend to decreased survival (29% versus 48%; P = 0.05) in one study 6. A third randomized trial, restricted to GOV1, found significantly lower rates of persistent or recurrent bleeding (16% versus 35%) with BCA 8…”