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An observational single-center study was carried out to examine the efficacy and safety of endoscopic ultrasound-guided coil and glue injection for primary prophylaxis of the gastric variceal hemorrhage.
In individuals having
elevated-risk gastric varices, the endoscopic ultrasound-guided coil and
cyanoacrylate injection is very effective for primary prophylaxis of gastric
variceal bleeding and is coupled with a low rate of adverse events.
An observational single-center
study was carried out to examine the efficacy and safety of endoscopic
ultrasound-guided coil and glue injection for primary prophylaxis of the
gastric variceal hemorrhage.
The study enrolled all adult subjects having elevated-risk gastric varices (size > 10 mm or cherry-red spot) without previous bleeding who underwent endoscopic ultrasound-guided coil and cyanoacrylate injection for primary prevention of gastric variceal bleeding. Post-therapy gastric variceal bleeding was the major endpoint.
The trial included 80 individuals having a mean variceal size of about 22.5±9.4
mm and mean length of follow-up 3.0±2.4 years. Etiology of portal hypertension
was noncirrhotic in 9 (11.3%) and cirrhosis in 71 (88.7%). The mean model for
end-stage liver disease (MELD) was 12.3±3.7 in cirrhosis subjects. The mean
coil number and glue volume injected were 1.5 (range 1-3) and 2 ml (range
0.5-5), respectively.
Technical
success was attained in 100%, 96.7% had endoscopic ultrasound confirmation of
gastric varices obliteration, and 67.7% were obliterated with the aid of one
therapy session. The noxious effects were witnessed in 4 (4.9%) patients while
the post-therapy gastric variceal bleeding was noted in 2 (2.5%) patients. No
mortality was associated with gastric variceal bleeding and there was no
requirement for emergent transjugular intrahepatic shunts during the trial
follow-up.
Endoscopic ultrasound-guided
coil and cyanoacrylate injection are very effective to prevent gastric variceal
bleeding. The prophylaxis of elevated-risk gastric varices with coil and
cyanoacrylate glue injection should be taken into consideration in healthcare
centers with suitable expertise.
Gastrointestinal Endoscopy
Safety and efficacy of EUS-guided coil and glue injection for the primary prophylaxis of gastric variceal hemorrhage
Abdul Kouanda et al.
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