<i>N</i>‐BUTYL‐2‐CYANOACRYLATE (HISTOACRYL) GLUE IN THE RIGHT ATRIUM AFTER ENDOSCOPIC INJECTION FOR A RUPTURED DUODENAL VARIX: COMPLICATION OF HISTOACRYL INJECTION

Miyakoda, Kenji; Takedatsu, Hidetoshi; Emori, Keigo; Inoue, Hiroto; Toyonaga, Atsushi; Mitsuyama, Keiichi; Takahashi, Osamu; Sata, Michio

doi:10.1111/j.1443-1661.2011.01185.x

Cited by 11 publications

(5 citation statements)

References 5 publications

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“…The treatment strategies currently used to control duodenal variceal bleeding are all either technically demanding or associated with procedure‐related severe complications. Endoscopic obliteration using cyanoacrylate injection is an effective first‐line treatment 26 but carries a major risk of portal or systemic embolization 27 . Endoscopic variceal band ligation is technically difficult in the duodenum and can cause severe ulcerations 28, 29 .…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic obliteration using cyanoacrylate injection is an effective first-line treatment 26 but carries a major risk of portal or systemic embolization. 27 Endoscopic variceal band ligation is technically difficult in the duodenum and can cause severe ulcerations. 28,29 Hemospray Õ could play a role in this instance as a bridge to secondary prophylaxis consisting of b-blockers or TIPS according to the severity of underlying liver disease.…”

Section: Discussionmentioning

confidence: 99%

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Management of acute variceal bleeding using hemostatic powder

et al. 2015

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Background and objectives: This study aimed to test the safety and efficacy of Hemospray Õ for emergency control of acute variceal bleeding (AVB) due to portal hypertension in cirrhotic patients. Patients and methods: This single-arm, prospective trial, conducted at two hospitals in Belgium and Egypt, included patients admitted to the emergency room with hematemesis and/or melena and known or suspected liver cirrhosis. All patients received urgent hemodynamic stabilization, octreotide (50 mcg bolus then 25 mcg/hour for 24 hours) and intravenous ceftriaxone (1 g/hour). Endoscopy to confirm AVB and Hemospray Õ application (if indicated) was performed within six hours of admission. Patients were kept under observation for 24 hours and underwent second endoscopy and definitive therapy (band ligation and/or cyanoacrylate injection in cases of gastric varices) the next day. Results: Thirty-eight patients were admitted for suspected AVB, and 30 of these had confirmed AVB (70% male; mean age 59.5 years (range, 32.0-73 years)). Child-Pugh class C liver disease was present in 53.4%. Esophageal varices were observed in 83.4% of patients, gastric varices in 10%, and duodenal varices in 6.6%. Spurting bleeding at the time of endoscopy was observed in 43.4%. One patient developed hematemesis six hours after Hemospray Õ application and underwent emergency endoscopic band ligation. No major adverse events or mortalities were observed during 15-day follow-up. Conclusion: Hemospray Õ application was safe and effective at short-term follow-up for emergency treatment of AVB in cirrhotic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of acute variceal bleeding using hemostatic powder

et al. 2015

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“…There were 5 cases of acrylic cement embolism among the 104 cases presented here, where 2 patients developed pulmonary embolism, 1 bloody pericardial effusion, 1 myocardial infarction, and 1 with rapid atrial flutter, congestive heart failure and moderate‐severe tricuspid regurgitation . In another patient other acryl‐based substances, such as histoacryl glue was used for the treatment of bleeding from varices during gastroscopy leak and through systemic venous circulation that reached the right atrium.…”

Section: Discussionmentioning

confidence: 96%

Foreign Bodies in the Heart

Leitman

Vered

2014

Echocardiography

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“…[18] Endoscopic injection of glue has been shown to be safe and effective therapeutic modality for DV but complications such as re-bleeding or thromboembolic complications have also been reported. [819]…”

Section: Discussionmentioning

confidence: 99%

Clinical, endoscopic and endoscopic ultrasound features of duodenal varices: A report of 10 cases

et al. 2014

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Background:Duodenal varices (DV) although an uncommon cause, are an important cause due to the severe nature of the bleed and associated adverse outcome.Materials and Methods:We retrospectively evaluated patients with DV seen at our institution over past 4 years.Results:A total of 10 patients (nine males; mean age was 35.8 ± 7.68 years) with DV were studied. Five patients had underlying cirrhosis and five had DV because of non-cirrhotic portal hypertension (four patients had extra-hepatic portal venous obstruction and one patient had non-cirrhotic portal fibrosis). Five patients presented with upper gastrointestinal (GI) bleed, whereas in the remaining five patients DV were detected on endoscopy performed for evaluation of portal hypertension. Endoscopy revealed submucosal lesion in nine patients, whereas in one patient an initial endoscopic diagnosis of Dieulafoy's lesion was made. However endoscopic ultrasound (EUS) could clearly identify DV in all patients. Of five patients presenting with upper GI bleed, three had the esophageal varices eradicated and two presented 1st time with bleed form DV and did not have esophagogastric varices. All patients with acute upper GI bleed were initially treated with intravenous terlipressin followed by glue (n-butyl cyanoacrylate) injection in 4/5 patients with one patient refusing further endoscopic therapy. The variceal obliteration was documented by EUS in all these four patients and there has been no recurrence of bleed in these four patients over a follow-up period of 4-46 months. The five non-bleeding DV were already on beta- blockers and the same were continued. Two of these five patients succumbed to progressive liver failure with none of these five patients having GI bleed on follow-up.Conclusion:EUS is a useful investigational modality for evaluating patients with DV and endoscopic injection of glue is an effective therapy for controlling and preventing recurrence of bleed from DV.

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N‐BUTYL‐2‐CYANOACRYLATE (HISTOACRYL) GLUE IN THE RIGHT ATRIUM AFTER ENDOSCOPIC INJECTION FOR A RUPTURED DUODENAL VARIX: COMPLICATION OF HISTOACRYL INJECTION

Cited by 11 publications

References 5 publications

Management of acute variceal bleeding using hemostatic powder

Management of acute variceal bleeding using hemostatic powder

Foreign Bodies in the Heart

Clinical, endoscopic and endoscopic ultrasound features of duodenal varices: A report of 10 cases

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