Project description:Mortality from acute variceal bleeding (AVB) has improved markedly over the last 2-3 decades due to increased specialisation and standardisation of medical and endoscopic practice culminating in the production of consensus guidance based on expert opinion. Nonetheless, despite greater exposure, training and endoscopic practices, 30-day mortality still remains high at around 30%. This is a reflection of the high morbidity with liver disease, and limited endoscopic experience and/or endoscopic techniques used by the majority of general endoscopists. Clinical necessity defines our drive for further endoscopic innovation to improve 'best practice' and, therefore, clinical outcomes accordingly. Sclerotherpy, variceal band ligation and/or rescue balloon tamponade have been entrenched in most treatment algorithms over the decades. However, in recent years and albeit limited to specialised liver centres, cyanoacrylate glue injection therapy (for oesophageal and gastric varices), and the placement of a self-expanding metallic stent for oesophageal varices have begun to offer improved endoscopic care in experienced hands. Yet even in specialised centres, their application is sporadic and operator dependent. Here, we discuss the evidence of these newer endoscopic approaches, and hope to propose their inclusion in endoscopic therapy algorithms for 'best practice' management of AVB in all appropriately supported endoscopy units.

| S-EPMC4484373 | biostudies-other

EUS-guided cyanoacrylate glue injection for treatment of anourethral fistula.

Project description: Not available

| S-EPMC5992786 | 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

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

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

Project description:Video 1.

| S-EPMC10665211 | biostudies-literature

A ruptured splenic artery aneurysm treated by transcatheter arterial embolization using n-butyl cyanoacrylate-Lipiodol-Iopamidol.

Project description:N-butyl cyanoacrylate, one of embolic materials, is usually used as a mixture with Lipiodol (N-butyl cyanoacrylate-Lipiodol mixture). N-butyl cyanoacrylate-Lipiodol-Iopamidol was developed by adding a nonionic iodine contrast agent (Iopamiron) to N-butyl cyanoacrylate-Lipiodol mixture. N-butyl cyanoacrylate-Lipiodol-Iopamidol has lower adhesiveness than N-butyl cyanoacrylate-Lipiodol mixture and the ability to form a single large droplet. We report the case of a 63-year-old man with a ruptured splenic artery aneurysm treated by transcatheter arterial embolization using N-butyl cyanoacrylate-Lipiodol-Iopamidol. He was referred to the emergency room because of sudden onset of upper abdominal pain. A diagnosis was established using contrast-enhanced computed tomography and angiography. Emergency transcatheter arterial embolization was performed, and the ruptured splenic artery aneurysm was successfully embolized using a combination of coil framing and N-butyl cyanoacrylate-Lipiodol-Iopamidol packing. This case demonstrates the usefulness of a combination of coil framing and N-butyl cyanoacrylate-Lipiodol-Iopamdol packing for the embolization of aneurysms.

| S-EPMC10172629 | biostudies-literature

Systematic review of the use of cyanoacrylate glue in addition to standard wound closure in the prevention of surgical site infection.

Project description:Surgical site infection (SSI) is associated with increased morbidity, length of stay, and cost. Cyanoacrylate glue is a low-cost, fluid-proof, antimicrobial barrier. The aim of this systematic review is to assess the use of cyanoacrylate glue after standard wound closure versus dressings in the reduction of SSI. Medline, Embase, Cochrane Library, and clinical trial registries were searched with no restrictions in accordance with PRISMA guidelines. Eligibility criteria were prospective studies comparing glue versus dressings after standardised wound closure. Two reviewers independently screened articles and utilised GRADE for quality assessment. Meta-analysis was not performed because of the heterogeneity of the data. Three articles were included in the review. Study quality was uniformly low. Incidence of SSI was low, between 0% and 4%. No significant differences were reported in the single randomised controlled trial. A single non-randomised parallel group trial reported a significant reduction in the incidence of SSI in the cyanoacrylate group. There was no consistent evidence demonstrating reduction in SSI as a result of the use of cyanoacrylate glue. Future studies should assess the use of cyanoacrylate in procedures with a higher rate of SSI, for example, lower limb bypass.

| S-EPMC7948799 | biostudies-literature

Cyanoacrylate glue for iatrogenic retinal breaks during vitrectomy in stage 5 familial exudative vitreoretinopathy.

Project description:PurposeTo describe the role of cyanoacrylate glue in sealing iatrogenic retinal breaks (IRBs) during vitrectomy in stage 5 familial exudative vitreoretinopathy (FEVR) with funneled retinal detachment (RD).MethodsNine eyes of nine patients diagnosed as stage 5 FEVR were treated with cyanoacrylate glue for IRBs during vitrectomy from July 2020 to January 2022. The clinical records, including patient information, surgical process, and follow-up examinations, were collected retrospectively. Anatomical outcomes and visual outcomes were summarized.ResultsThe average age at surgery was 19.6 months (range: 3.8-41.1 months). The mean post-operative follow-up period was 12.5 months (range: 9.8-18.8 months). Before surgery, five eyes had an open-funnel RD and four eyes had a closed-funnel RD. All the preretinal fibroplasia membranes were removed as thoroughly as possible in the nine eyes. IRBs formed at the posterior pole in two eyes and peripheral retina in seven eyes. All the IRBs were sealed successfully by the cyanoacrylate glue when they appeared. At the final post-operative visit, eight eyes had partial retinal reattachment without progression of fibroplasia tissues, while one eye had total retinal redetachment. The rate for stable anatomical outcome was 88.9% (8/9) in this study. The visual testing available for seven eyes demonstrated light perception in five eyes and no light perception in two eyes. No severe perioperative glue-related complications were noted during the follow-ups.ConclusionThe application of cyanoacrylate glue may be an alternative therapy for IRBs in stage 5 FEVR surgeries, while the long-term efficacy and safety still need further investigation.

| S-EPMC11222635 | biostudies-literature

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