Endoscopic Sclerotherapy of Gastric Variceal Bleeding with N-Butyl-2-Cyanoacrylate

Dhiman, Radha K.; Chawla, Yogesh; Taneja, Sameer; Biswas, Rakesh; Sharma, Tilak Raj; Dilawari, J. B.

doi:10.1097/00004836-200209000-00005

Cited by 92 publications

(65 citation statements)

References 17 publications

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“…Most reports on endoscopic treatment of bleeding gastric varices are small series, case reports, or retrospective reviews [14,15] . Not more than 1000 patients with bleeding GV have been treated with different sclerosing and coagulating agents.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of gastric varices and results of sclerotherapy with N-butyl 2 cyanoacrylate for controlling acute gastric variceal bleeding

Mumtaz

Majid²,

Shah³

et al. 2007

WJG

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AIM:To study the prevalence, predictors and control of bleeding following N-butyl 2 cyanoacrylate (NBC) sclerotherapy of gastric varix (GV). METHODS:We analyzed case records of 1436 patients with portal hypertension, who underwent endoscopy during the past five years for variceal screening or upper gastrointestinal (GI) bleeding. Fifty patients with bleeding GV underwent sclerotherapy with a mean of 2 mL NBC for control of bleeding. Outcome parameters were primary hemostasis (bleeding control within the first 48 h), recurrent bleeding (after 48 h of esophagogastro-duodenoscopy) and in-hospital mortality were analyzed. RESULTS:The prevalence of GV in patients with portal hypertension was 15% (220/1436) and the incidence of bleeding was 22.7% (50/220). Out of the 50 bleeding GV patients, isolated gastric varices (IGV-I) were seen in 22 (44%), gastro-oesophageal varices (GOV) on lesser curvature (GOV-Ⅰ) in 16 (32%), and GOV on greater curvature (GOV-Ⅱ) in 15 (30%). IGV-Ⅰ was seen in 44% (22/50) patients who had bleeding as compared to 23% (39/170) who did not have bleeding (P < 0.003). Primary hemostasis was achieved with NBC in all patients. Re-bleeding occurred in 7 (14%) patients after 48 h of initial sclerotherapy. Secondary hemostasis was achieved with repeat NBC sclerotherapy in 4/7 (57%). Three patients died after repeat sclerotherapy, one during transjugular intrahepatic portosystemic stem shunt (TIPSS), one during surgery and one due to uncontrolled bleeding. Treatment failure-related mortality rate was 6% (3/50). CONCLUSION:GV can be seen in 15% of patients with portal hypertension and the incidence of bleeding is 22.7%. NBC is highly effective in controlling GV bleeding. In hospital mortality of patients with bleeding GV is 6%.

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Section: Introductionmentioning

confidence: 99%

Prevalence of gastric varices and results of sclerotherapy with N-butyl 2 cyanoacrylate for controlling acute gastric variceal bleeding

Mumtaz

Majid²,

Shah³

et al. 2007

WJG

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“…Other authors did not report on echocardiographic findings and have presumed that the paradoxical embolization occurred via an arteriovenous pulmonary shunt [16,17]. In the case series, no echocardiographic study was mentioned [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Both pulmonary and systemic embolisms have been reported. Table 1 shows the case series on the incidence of various embolic complications following gastric varices injection with Histoacryl in six centers [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

et al. 2009

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“…57 Gastric varices, which are more common in JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY NCPF, can be managed with cyanoacrylate glue injection. 58,59 Splenic artery embolization, percutaneous transhepatic obliteration, and a transjugular intrahepatic portosystemic shunt (TIPSS) are other options in the primary prevention of variceal bleeding. 60 The role of surgery is limited to those who fail to respond to endoscopic therapy.…”

Section: Managementmentioning

confidence: 99%

Noncirrhotic Portal Hypertension

Rajekar¹,

Vasishta²,

Chawla³

et al. 2011

Journal of Clinical and Experimental Hepatology

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Portal hypertension is characterized by an increase in portal pressure (> 10 mmHg) and could be a result of cirrhosis of the liver or of noncirrhotic diseases. When portal hypertension occurs in the absence of liver cirrhosis, noncirrhotic portal hypertension (NCPH) must be considered. The prognosis of this disease is much better than that of cirrhosis. Noncirrhotic diseases are the common cause of portal hypertension in developing countries, especially in Asia. NCPH is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies. In general, the lesions in NCPH are vascular in nature and can be classified based on the site of resistance to blood flow. In most cases, these disorders can be explained

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Endoscopic Sclerotherapy of Gastric Variceal Bleeding with N-Butyl-2-Cyanoacrylate

Abstract: sclerotherapy of gastric varices with BC is a safe and an effective treatment for control of bleeding and eradication. The needle should be withdrawn immediately after the BC injection to prevent its impaction into the tissue adhesive.

Cited by 92 publications

References 17 publications

Prevalence of gastric varices and results of sclerotherapy with N-butyl 2 cyanoacrylate for controlling acute gastric variceal bleeding

Prevalence of gastric varices and results of sclerotherapy with N-butyl 2 cyanoacrylate for controlling acute gastric variceal bleeding

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

Noncirrhotic Portal Hypertension

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