PMID- 36845270
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230228
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 2
DP  - 2023 Feb
TI  - EUS-guided cyanoacrylate injection into the perforating vein versus direct 
      endoscopic injection in the treatment of gastric varices.
PG  - E202-E210
LID - 10.1055/a-1984-7070 [doi]
AB  - 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.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Sabry, Fady
AU  - Sabry F
AD  - Mansoura University Faculty of Medicine, Department of Gastroenterology and 
      Hepatology, Mansoura, Egypt.
FAU - Seif, Seham
AU  - Seif S
AD  - Mansoura University Faculty of Medicine, Department of Gastroenterology and 
      Hepatology, Mansoura, Egypt.
FAU - Eldesoky, Ayman
AU  - Eldesoky A
AD  - Mansoura University Faculty of Medicine, Department of Gastroenterology and 
      Hepatology, Mansoura, Egypt.
FAU - Hakim, Hazem
AU  - Hakim H
AD  - Mansoura University Faculty of Medicine, Department of Gastroenterology and 
      Hepatology, Mansoura, Egypt.
FAU - Altonbary, Ahmed Youssef
AU  - Altonbary AY
AD  - Mansoura University Faculty of Medicine, Department of Gastroenterology and 
      Hepatology, Mansoura, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20230223
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9949986
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2023/02/28 06:00
MHDA- 2023/02/28 06:01
PMCR- 2023/02/01
CRDT- 2023/02/27 05:01
PHST- 2022/09/30 00:00 [received]
PHST- 2022/11/18 00:00 [accepted]
PHST- 2023/02/27 05:01 [entrez]
PHST- 2023/02/28 06:00 [pubmed]
PHST- 2023/02/28 06:01 [medline]
PHST- 2023/02/01 00:00 [pmc-release]
AID - 10.1055/a-1984-7070 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Feb 23;11(2):E202-E210. doi: 10.1055/a-1984-7070. 
      eCollection 2023 Feb.