title: [Long-term results of endoscopic histoacryl (N-butyl-2-cyanoacrylate) injection for treatment of gastric varices--a 10-year experience].
abstract: OBJECTIVE
  Gastric variceal bleeding is an infrequent but serious complication of portal hypertension. Endoscopic injection of Histoacryl (N-butyl-2-cyanoacrylate) has been approved as an effective treatment for gastric variceal bleeding. The aim of this study was to evaluate the long-term efficacy and safety of the endoscopic injection of Histoacryl for the treatment of gastric varices.
  
  
  METHODS
  Between January 1994 and January 2005, eighty-five patients with gastric varices received endoscopic injections of Histoacryl. Among these 85 patients, 65 received the procedure within 1 week after gastric variceal bleeding, and 13 received as a prophylactic procedure. According to the Sarin classification, 32 patients were GOV1 and 53 were GOV2. Most of the varices were large (F2 or F3, 75 patients). The average volume of Histoacryl per each session was 1.43 ml. Among 85 patients, 72 patients were followed-up and the median duration was 24.5 months.
  
  
  RESULTS
  The rate of initial hemostasis was 98.6% and recurrent bleeding occurred in 29.2% (21 of 72). When rebleeding occurred, 76.2% was within 1 year after the initial injection. Treatment failure-related mortality rate was 1.4% (1 of 85). Twenty-seven patients died, mostly due to hepatocelluar carcinoma or liver failure. Two patients experienced pulmonary embolism and one experienced splenic infarction. They recovered without specific treatment. Rebleeding rate had a tendency to increase in patients with hepatocelluar carcinoma (p=0.051) and GOV2 (p=0.061).
  
  
  CONCLUSIONS
  Histoacryl injection therapy is a effective treatment method for gastric varices with high initial hemostasis rate and low major complications.
authors.affiliation: Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Joo
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Soo Hoon
authors.initials: SH
authors.lastname: Eun
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Kim
authors.forename: In Seop
authors.initials: IS
authors.lastname: Jung
authors.forename: Chang Beom
authors.initials: CB
authors.lastname: Ryu
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Kim
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Yun Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Lee
authors.forename: Chan Sup
authors.initials: CS
authors.lastname: Shim
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004659:Enbucrilate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D012597:Sclerosing Solutions; D004659:Enbucrilate