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Comparative Study
. 2008 Nov;22(11):931-6.
doi: 10.1155/2008/389517.

Endoscopic management of gastric varices: efficacy and outcomes of gluing with N-butyl-2-cyanoacrylate in a North American patient population

P J Belletrutti  1 , J Romagnuolo, R J Hilsden, F Chen, B Kaplan, J Love, P L Beck
Affiliations
Comparative Study

Endoscopic management of gastric varices: efficacy and outcomes of gluing with N-butyl-2-cyanoacrylate in a North American patient population

P J Belletrutti et al. Can J Gastroenterol. 2008 Nov.

Abstract
in English, French

Background: Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension. Outside of North America, gastric variceal injection of N-butyl-2-cyanoacrylate has been shown to be safe and effective. The majority of studies on this mode of therapy are in Asian populations in which the etiology of portal hypertension differs from North America.

Aim: To assess the safety and efficacy of gastric variceal glue injection in a North American population.

Methods: Consecutive patients that underwent glue injection of gastric varices in the Calgary Health Region from 2001 to 2006 were assessed.

Results: Thirty-four patients (19 men, 15 women) underwent a total of 47 separate gluing procedures. Of those presenting with active bleeding at endoscopy, immediate hemostasis was achieved in 93.8% of patients. Rebleeding within 48 h of gluing was observed after four procedures. Gastric varices were eradicated in 84.0% of cases. Complications included superior mesenteric vein thrombosis in one patient. Twenty-eight (82.4%) patients were alive at the end of follow-up. The treatment failure-related mortality rate was 2.1%.

Conclusions: The present study is one of the few to assess the role of gastric variceal gluing in a North American population. Glue injection with cyanoacrylate is safe and effective in the treatment of bleeding gastric varices.

HISTORIQUE :: Les hémorragies causées par des varices gastriques s’associent à une importante morbidité et à une importante mortalité chez les patients ayant une hypertension portale. À l’extérieur de l’Amérique du Nord, il est démontré que l’injection de N-butyl-2-cyanoacrylate pour obturer les varices gastriques est sécuritaire et efficace. La majorité des études sur ce mode de thérapie ont eu lieu auprès de populations asiatiques, pour qui l’étiologie de l’hypertension portale diffère de celles d’Amérique du Nord.

OBJECTIF :: Évaluer la sécurité et l’efficacité de l’obturation des varices gastriques à la colle au sein d’une population nord-américaine.

MÉTHODOLOGIE :: Les auteurs ont évalué des patients consécutifs de la région sanitaire de Calgary qui ont reçu une injection de colle dans des varices gastriques entre 2001 et 2006.

RÉSULTATS :: Trente-quatre patients (19 hommes, 15 femmes) ont subi un total de 47 interventions distinctes d’obturation à la colle. Ainsi, 93,8 % des patients qui présentaient une hémorragie active à l’endoscopie sont parvenus à une hémostasie immédiate. On a observé la reprise de l’hémorragie dans les 48 heures suivant l’injection de colle après quatre interventions. Les varices gastriques ont été éradiquées dans 84,0 % des cas. Les complications ont inclus une thrombose de la veine mésentérique supérieure chez un patient. Vingt-huit (82,4 %) patients étaient vivants à la fin du suivi. Le taux de mortalité relié à l’échec du traitement s’élevait à 2,1 %.

CONCLUSIONS :: La présente étude est l’une des rares à évaluer le rôle de l’obturation des varices gastriques à la colle au sein d’une population nord-américaine. L’injection de colle contenant du cyanoacrylate est sécuritaire et efficace dans le traitement d’hémorragies causées par des varices gastriques.

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Figures

Figure 1)
Figure 1)
Coronal oblique reformation of the abdomen from an oral and intravenous contrast-enhanced computed tomography scan acquired in the portal venous phase. Extensive hypo-attenuating material filling the slightly dilated superior mesenteric vein (arrows) and several feeding branches is consistent with acute thrombosis
See this image and copyright information in PMC

References

    1. Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK. Prevalence, classification and natural history of gastric varices: A long-term follow-up study in 568 portal hypertension patients. Hepatology. 1992;16:1343–9. - PubMed
    1. Thakeb F, Salem SA, Abdallah M, el Batanouny M. Endoscopic diagnosis of gastric varices. Endoscopy. 1994;26:287–91. - PubMed
    1. Sarin SK, Jain AK, Jain M, Gupta R. A randomized controlled trial of cyanoacrylate versus alcohol injection in patients with isolated fundic varices. Am J Gastroenterol. 2002;97:1010–5. - PubMed
    1. Kind R, Guglielmi A, Rodella L, et al. Bucrylate treatment of bleeding gastric varices: 12 years’ experience. Endoscopy. 2000;32:512–9. - PubMed
    1. Akahoshi T, Hashizume M, Shimabukuro R, et al. Long-term results of endoscopic Histoacryl injection sclerotherapy for gastric variceal bleeding: A 10-year experience. Surgery. 2002;131(Suppl):S176–81. - PubMed

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