Project description:Background and study aims Endoscopic injection of gastric varices (GVs) using cyanoacrylate (CYA) is associated with significant adverse events (AEs). We aimed to compare the efficacy and safety of endoscopic ultrasound (EUS)-guided CYA injection into the perforating vein versus direct endoscopic injection (DEI) of CYA in treatment of high-risk GVs. Patients and methods This was a randomized controlled trial that included 52 patients with high-risk GVs. Group A underwent EUS-guided injection into the perforator vein and Group B underwent DEI of 1 mL CYA. Endoscopic examination and Doppler EUS were repeated after 3 months to confirm eradication. Obliteration by Doppler EUS was considered by absence of Doppler flow within the varix. Repeated injection was performed in the absence of obliteration. Doppler EUS examination was repeated at 3 and 6 months after each injection. Results Forty-three patients including 27 males and 16 females with mean age 57 years completed the study. Variceal obliteration was achieved during the index session after 3 months in eight of 21 (38.1 %) in group B compared to 17 of 22 (77.2 %) in group A ( P = 0.014). There was a significant difference in the amount of CYA needed to achieve obliteration in group B compared to group A (2 vs.1 mL, P = 0.027). There was no statistically significant difference in the overall AE rate between group A and group B (4.5 % vs. 14.3 %, P = 0.345). Conclusions EUS-guided CYA injection into the perforating veins achieved less amount of CYA, fewer number of sessions to obliteration, and similar overall AE rates in the treatment of high-risk GVs compared to DEI.

| S-EPMC9949986 | biostudies-literature

EUS-guided n-butyl-2-cyanoacrylate injection therapy for ruptured isolated left gastric artery pseudoaneurysm.

Project description: Not available

| S-EPMC6400093 | biostudies-literature

EUS-guided arterial embolization with cyanoacrylate glue of a pancreatic neuroendocrine tumor infiltrating the gastric wall causing upper GI bleeding.

Project description: Not available

| S-EPMC5991010 | biostudies-literature

Successful obliteration of bleeding duodenal varices by EUS-guided injection of <i>N</i>-butyl-2-cyanoacrylate.

Project description: Not available

| S-EPMC6031286 | biostudies-literature

A Sticky Situation: An Uncommon Cardiac Complication of Cyanoacrylate Glue Injection.

Project description:This case report describes an uncommon cardiac complication related to the endoscopic injection of cyanoacrylate glue to treat gastric variceal bleeding. The presentation and management options are reviewed and compared with our step-by-step approach in a patient requiring a liver transplant. (Level of Difficulty: Advanced.).

| S-EPMC10366504 | biostudies-literature

Endoscopic ultrasound-guided injection of coils and cyanoacrylate glue for the treatment of gastric fundal varices with abnormal shunts: a series of case reports.

Project description:Gastric varices are found in approximately 20% of patients with portal hypertension. Endoscopic procedures involving the injection of cyanoacrylate (CYA) have proven to be the therapies of choice for primary treatment of gastric varices and have resulted in higher hemostasis rates and lower recurrent bleeding rates compared with band ligation and sclerotherapy. Nevertheless, serious adverse events associated with CYA injection, including glue embolization, have been reported in numerous articles and have occasionally led to fatal adverse events. Gastric fundal varices with abnormal shunts are higher-risk than those without abnormal shunts, and their treatment is more challenging. Endoscopic ultrasound (EUS)-guided puncture is an important technique in the field of digestive endoscopy. EUS has advantages that include improved therapeutic targeting, enhanced variceal detection, the ability to confirm varix obliteration with Doppler examination, and the ability to perform accurate observations of gastric varices that are not affected by blood in the stomach. The coils currently used for intravascular embolization can be precisely delivered into a varix through fine-needle puncture under EUS guidance, and this technique has provided a new approach for varix obliteration. We herein describe two patients with severe gastric fundal varices who were treated with EUS-guided coil injection and CYA embolization.

| S-EPMC6460599 | biostudies-literature

EUS-guided glue injection for managing torrential bleeding during gastric neuroendocrine tumor endoscopic submucosal dissection: sealing the storm

Project description: Not available

| S-EPMC11551515 | biostudies-literature

Balloon-occluded retrograde transvenous obliteration combined with EUS-guided coil embolization and endoscopic cyanoacrylate injection therapy of gastric varices with huge gastrorenal shunt (with videos).

Project description: Not available

| S-EPMC10134918 | biostudies-literature

A case of duodenal variceal bleeding treated by Doppler-guided endoscopic cyanoacrylate injection.

Project description:Video 1.

| S-EPMC10665211 | biostudies-literature