title: N-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and hypertonic glucose with 72% chromated glycerin in gastric varices.
abstract: OBJECTIVE
  To compare n-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and a mixture of 72% chromated glycerin with hypertonic glucose solution in management of gastric varices.
  
  
  METHODS
  Ninety patients with gastric varices presented to Endoscopy Unit of Ain Shams University Hospital were included. They were randomly allocated into three groups; each group included 30 patients treated with intravariceal sclerosant injections in biweekly sessions till complete obturation of gastric varices; Group I (n-butyl-2-cyanoacrylate; Histoacryl(®)), Group II (iso-amyl-2-cyanoacrylate; Amcrylate(®)) and Group III (mixture of 72% chromated glycerin; Scleremo(®) with glucose solution 25%). All the procedures were performed electively without active bleeding. Recruited patients were followed up for 3 mo.
  
  
  RESULTS
  26% of Scleremo group had bleeding during puncture vs 3.3% in each of the other two groups with significant difference, (P < 0.05). None of Scleremo group had needle obstruction vs 13.3% in each of the other two groups with no significant difference, (P > 0.05). Rebleeding occurred in 13.3% of Histoacryl and Amcrylate groups vs 0% in Scleremo group with no significant difference. The in hospital mortality was 6.6% in both Histoacryl and Amcrylate groups, while it was 0% in Scleremo group with no significant difference. In the first and second sessions, the amount of Scleremo needed for obturation was significantly high, while the amount of Histoacryl was significantly low. Scleremo was the less costly of the two treatments.
  
  
  CONCLUSIONS
  All used sclerosant substances showed efficacy and success in management of gastric varices with no significant differences except in total amount, cost and bleeding during puncture.
authors.affiliation: Reda Elwakil, Mohamed Fawzy Montasser, Sara M Abdelhakam, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt.
authors.forename: Reda
authors.initials: R
authors.lastname: Elwakil
authors.affiliation: Reda Elwakil, Mohamed Fawzy Montasser, Sara M Abdelhakam, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt.
authors.forename: Mohamed Fawzy
authors.initials: MF
authors.lastname: Montasser
authors.affiliation: Reda Elwakil, Mohamed Fawzy Montasser, Sara M Abdelhakam, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Abdelhakam
authors.affiliation: Reda Elwakil, Mohamed Fawzy Montasser, Sara M Abdelhakam, Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo 11341, Egypt.
authors.forename: Wesam A
authors.initials: WA
authors.lastname: Ibrahim
keywords: 72% chromated glycerin; Gastric varices; Hypertonic glucose solution; Iso-amyl-2-cyanoacrylate; N-butyl-2-cyanoacrylate