Endoscopy cornerLow Incidence of Complications From Endoscopic Gastric Variceal Obturation With Butyl Cyanoacrylate
Section snippets
Patients
The patient population consisted of 3346 consecutively admitted patients with episodes of variceal bleeding who received endoscopic therapy and were hospitalized in either the General Hospital of Chinese People's Liberation Army (GHCPLA) between January 1996 and April 2006 or Beijing Shijitan Hospital (BSH) between March 2003 and December 2007. This study population was divided into 2 groups, a cohort comprising 2953 cases with esophageal variceal bleeding who received either EVL or EVS and 753
Follow-up
A total of 49 patients (49 of 753, 6.5%) died, and 68 patients were lost during follow-up. The causes of death were 14 cases from liver failure, 14 from uncontrolled upper gastrointestinal bleeding, 11 from liver cancer, 3 from infection and sepsis, 2 from renal failure, and the remaining 5 from other diseases not related to portal hypertension. The survival analysis has been reported elsewhere.12
Rebleeding Due to Early-Onset Extrusion of N-Butyl-2-Cyanoacrylate Cast
Glue cast extrusion usually began 1 month after treatment and rarely occurred after the first year.
Discussion
The use of N-butyl-2-cyanoacrylate for gastric varices treatment was first introduced in 1987.14 Despite its efficacy, EVO with cyanoacrylate can create complications4 including early polymerization leading to needle adhesion to the varices, embolization, bacteremia, esophageal perforation, peritoneal cavity extravasation, and splenic infarction.4, 15, 16, 17
Thromboembolism is a primary complication of EVO with tissue glue. All 5 embolic cases occurred with sandwich injection. The volume of
Acknowledgments
The authors thank Dr James W. Shih from the National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University for his substantial help in the preparation of this paper.
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Conflicts of interest The authors disclose no conflicts.
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