EUS-guided injection of cyanoacrylate in perforating feeding veins in gastric varices: results in 5 cases

Endoscopic ultrasound-guided vascular intervention for portal hypertension

“…12 The mean number of sessions required for GV obliteration was 1.6 session, with no rebleeding during a mean follow-up period of 10 months. 12 One of the feared serious complications of CYA injection is distant CYA embolization. Combining coil with CYA injection may theoretically reduce the risk CYA embolization and the amount of CYA needed during treatment.…”

“…[10][11][12][13][14][15][16] Fig. 3 illustrate GV obliteration by EUSguided CYA injection with Doppler monitoring.…”

“…[10][11][12][13][14][15][16] In general, a 19 G or 22 G standard EUS needle can be used for EUSguided intravascular puncture of the target varices. [10][11][12][13][14][15][16] Tissue adhesives in the form of CYA (e.g., N-butyl-2-CYA, 2-Octyl-CYA) with or without lipiodol, or sclerosing agents (e.g., ethanolamine) have been used for EUS-guided injection therapy of gastroesoph- A B ageal varices.…”

“…[10][11][12][13][14][15][16] In general, a 19 G or 22 G standard EUS needle can be used for EUSguided intravascular puncture of the target varices. [10][11][12][13][14][15][16] Tissue adhesives in the form of CYA (e.g., N-butyl-2-CYA, 2-Octyl-CYA) with or without lipiodol, or sclerosing agents (e.g., ethanolamine) have been used for EUS-guided injection therapy of gastroesoph- A B ageal varices. [10][11][12][13][14][15][16] While fluoroscopy is not required during injection therapy of varices with CYA under EUS guidance, fluoroscopy can be beneficial during EUS-guided coiling procedures with or without CYA injection.…”

“…[10][11][12][13][14][15][16] Tissue adhesives in the form of CYA (e.g., N-butyl-2-CYA, 2-Octyl-CYA) with or without lipiodol, or sclerosing agents (e.g., ethanolamine) have been used for EUS-guided injection therapy of gastroesoph- A B ageal varices. [10][11][12][13][14][15][16] While fluoroscopy is not required during injection therapy of varices with CYA under EUS guidance, fluoroscopy can be beneficial during EUS-guided coiling procedures with or without CYA injection. After injection therapy, EUS Doppler is used to provide real-time monitoring of variceal flow obliteration.…”