Long-term outcomes of prophylactic endoscopic histoacryl injection for gastric varices with a high risk of bleeding

Yun Jung Chang, Jong Jae Park, Moon Kyung Joo, Beomjae Lee, Jae Won Yun, Dae Woong Yoon, Ji Hoon Kim, Jong Eun Yeon, Jae Seon Kim, Kwan Soo Byun, Young-Tae Bak

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19 Citations (Scopus)

Abstract

Purpose: Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding. Methods: Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1. Results: Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95%) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14%) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8%). Conclusions: Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.

Original languageEnglish
Pages (from-to)2391-2397
Number of pages7
JournalDigestive Diseases and Sciences
Volume55
Issue number8
DOIs
Publication statusPublished - 2010 Aug 1

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Enbucrilate
Esophageal and Gastric Varices
Hemorrhage
Injections
Safety
Bacteremia
Stomach

Keywords

  • Butyl cyanoacrylate
  • Endoscopic sclerotherapy
  • Gastric varices

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

@article{c6905eba15e44ffbbccdbbd491514a54,
title = "Long-term outcomes of prophylactic endoscopic histoacryl injection for gastric varices with a high risk of bleeding",
abstract = "Purpose: Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding. Methods: Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1. Results: Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95{\%}) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14{\%}) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8{\%}). Conclusions: Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.",
keywords = "Butyl cyanoacrylate, Endoscopic sclerotherapy, Gastric varices",
author = "Chang, {Yun Jung} and Park, {Jong Jae} and Joo, {Moon Kyung} and Beomjae Lee and Yun, {Jae Won} and Yoon, {Dae Woong} and Kim, {Ji Hoon} and Yeon, {Jong Eun} and Kim, {Jae Seon} and Byun, {Kwan Soo} and Young-Tae Bak",
year = "2010",
month = "8",
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doi = "10.1007/s10620-009-1023-x",
language = "English",
volume = "55",
pages = "2391--2397",
journal = "American Journal of Digestive Diseases",
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T1 - Long-term outcomes of prophylactic endoscopic histoacryl injection for gastric varices with a high risk of bleeding

AU - Chang, Yun Jung

AU - Park, Jong Jae

AU - Joo, Moon Kyung

AU - Lee, Beomjae

AU - Yun, Jae Won

AU - Yoon, Dae Woong

AU - Kim, Ji Hoon

AU - Yeon, Jong Eun

AU - Kim, Jae Seon

AU - Byun, Kwan Soo

AU - Bak, Young-Tae

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Purpose: Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding. Methods: Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1. Results: Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95%) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14%) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8%). Conclusions: Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.

AB - Purpose: Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding. Methods: Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1. Results: Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95%) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14%) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8%). Conclusions: Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.

KW - Butyl cyanoacrylate

KW - Endoscopic sclerotherapy

KW - Gastric varices

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