An open pilot study of the effects of a human fibrin glue for endoscopic treatment of patients with acute bleeding from gastric varices.
BACKGROUND
Optimal treatment for gastric variceal bleeding remains to be determined. The use of conventional sclerosing agents is associated with high rates of recurrent bleeding. Other agents, such as cyanoacrylate, have significant complication rates and can damage endoscopic equipment. The risk of prior-associated disease has caused concern regarding the use of bovine thrombin.


METHODS
Beriplast-P (human thrombin) forms a fibrin clot at the needle tip immediately upon injection through a double lumen needle. In 10 patients with gastric variceal bleeding, a median dose of 6 mL of Beriplast-P was injected into gastric varices.


METHODS
Immediate hemostasis was achieved in 7 of 10 patients (70%) with a single injection. At a median follow-up of 8 months, there was no recorded episode of recurrent bleeding from gastric varices.


CONCLUSIONS
These results suggest that Beriplast-P is useful in the treatment of gastric variceal bleeding. Refinements in the design of the injection needle may improve the efficacy of this novel therapy.
Heneghan
Michael A
MA
Institute of Liver Studies, King's College Hospital, Denmark Hill, London SF5 9PJ, England.
Byrne
Anne
A
Harrison
Phillip M
PM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects* / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005773:Gastroscopy; D006490:Hemostatics / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics