title: Long-term outcomes of prophylactic endoscopic histoacryl injection for gastric varices with a high risk of bleeding.
abstract: OBJECTIVE
  Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding.
  
  
  METHODS
  Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1.
  
  
  RESULTS
  Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95%) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14%) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8%).
  
  
  CONCLUSIONS
  Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.
authors.affiliation: Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Jong-Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Moon Kyung
authors.initials: MK
authors.lastname: Joo
authors.forename: Beom Jae
authors.initials: BJ
authors.lastname: Lee
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Yun
authors.forename: Dae-Woong
authors.initials: DW
authors.lastname: Yoon
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Kim
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Byun
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bak
mesh_terms: D000328:Adult; D000368:Aged; D004659:Enbucrilate / Q000008:administration & dosage* / Q000627:therapeutic use*; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D012597:Sclerosing Solutions; D004659:Enbucrilate