Injection sclerotherapy for gastric varices using N-butyl-2-cyanoacrylate and ethanolamine oleate.
OBJECTIVE
Tissue adhesive agents, such as the cyanoacrylates, have been used as an alternative to conventional sclerotherapy to treat gastric varices, but the long-term efficacy of this approach has not been determined. We evaluated the efficacy and long-term outcome of injection sclerotherapy with n-butyl-2-cyanoacrylate and ethanolamine oleate in 16 patients with gastric varices.


METHODS
We evaluated the effect of injection sclerotherapy in 16 Japanese patients with gastric varices. Injection sclerotherapy was performed on an emergency basis in 6 patients, an elective basis in 5 patients, and as prophylaxis in 5 patients.


RESULTS
No bleeding was observed in the 7 patients in whom gastric varices disappeared during the 51 month follow-up period. The non-bleeding rate after treatment was significantly higher in this group than in the 9 patients in whom gastric varices did not disappear (p<0.05). Acute bleeding was stopped in 5 (83.3%) of 6 patients. The single failure was a patient in whom the sclerosant could not be injected into the gastric varices. No serious complications, such as emboli in other organs, were observed.


CONCLUSIONS
The results suggest that this therapy is a safe and useful treatment for gastric varices and that the goal of injection sclerotherapy should be the disappearance of gastric varices.
First Department of Internal Medicine, Yamaguchi University, Ube-City, Japan.
S
S
Miyazaki
T
T
Yoshida
T
T
Harada
T
T
Shigemitsu
Y
Y
Takeo
K
K
Okita
D018572:Disease-Free Survival; D004659:Enbucrilate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use*; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome
D009829:Oleic Acids; D012597:Sclerosing Solutions; D004659:Enbucrilate; C033343:ethanolamine oleate