Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate
Context Gastric variceal (GV) bleeding is a serious complication in patients with cirrhosis, as it is usually severe with high rate of mortality and rebleeding. Aim The aim of this study was to evaluate the efficacy and safety of endoscopic therapy with isoamyl-2-cyanoacrylate (Amcrylate) in patient...
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| Format: | Article |
| Language: | English |
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General Organization of Teaching Hospitals and Institutes
2019-01-01
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| Series: | Journal of Medicine in Scientific Research |
| Subjects: | |
| Online Access: | http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2019;volume=2;issue=1;spage=36;epage=41;aulast=Fouad |
| _version_ | 1797229029429870592 |
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| author | Tarek A Fouad El Saied E. Shabaan |
| author_facet | Tarek A Fouad El Saied E. Shabaan |
| author_sort | Tarek A Fouad |
| collection | DOAJ |
| description | Context
Gastric variceal (GV) bleeding is a serious complication in patients with cirrhosis, as it is usually severe with high rate of mortality and rebleeding.
Aim
The aim of this study was to evaluate the efficacy and safety of endoscopic therapy with isoamyl-2-cyanoacrylate (Amcrylate) in patients with cirrhosis with GV (gastroesophageal varices type 2 and isolated gastric varices type 1) bleeding.
Patients and methods
We prospectively studied 34 patients with cirrhosis with bleeding GV who were treated with intravariceal injection of isoamyl-2-cyanoacrylate (Amcrylate).
Statistical method
Data were expressed as the mean ± SD or as number (%) for numerical variables.
Results
After a mean dose of 1.86 ± 0.49 ml (range: 1–3 ml) of isoamyl-2-cyanoacrylate was injected in each patient, hemostasis was achieved initially in 100% of patients and complete obliteration of GV in 100% of patients. Treatment-related complications occurred in 26.5% of patients (9/34), but all complications were transient and mild. Complications included ulceration at site of injection (8.8%), fever (2.9%), abdominal pain (5.8%), chest pain (5.8%), and transient dysphagia (2.9%). Only one (2.9%) patient died closed to the cyanoacrylate treatment during hospitalization owing to hepatic encephalopathy and hepatorenal syndrome type I. During mean follow-up of 11.9 + 5.2 months (range: 2 weeks–21 months), rebleeding occurred in 8.8% of our patients.
Conclusion
This study has demonstrated the efficacy and safety of endoscopic treatment of bleeding GV using isoamyl-2-cyanoacrylate injection with initial hemostasis and complete obliteration of GV with no serious complications and low risk of rebleeding and bleeding-related death. |
| first_indexed | 2024-04-24T15:06:06Z |
| format | Article |
| id | doaj.art-30ea5a24db494b159789a75a5d0bc7b5 |
| institution | Directory Open Access Journal |
| issn | 2537-091X 2537-0928 |
| language | English |
| last_indexed | 2024-04-24T15:06:06Z |
| publishDate | 2019-01-01 |
| publisher | General Organization of Teaching Hospitals and Institutes |
| record_format | Article |
| series | Journal of Medicine in Scientific Research |
| spelling | doaj.art-30ea5a24db494b159789a75a5d0bc7b52024-04-02T13:02:53ZengGeneral Organization of Teaching Hospitals and InstitutesJournal of Medicine in Scientific Research2537-091X2537-09282019-01-0121364110.4103/JMISR.JMISR_11_19Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylateTarek A FouadEl Saied E. ShabaanContext Gastric variceal (GV) bleeding is a serious complication in patients with cirrhosis, as it is usually severe with high rate of mortality and rebleeding. Aim The aim of this study was to evaluate the efficacy and safety of endoscopic therapy with isoamyl-2-cyanoacrylate (Amcrylate) in patients with cirrhosis with GV (gastroesophageal varices type 2 and isolated gastric varices type 1) bleeding. Patients and methods We prospectively studied 34 patients with cirrhosis with bleeding GV who were treated with intravariceal injection of isoamyl-2-cyanoacrylate (Amcrylate). Statistical method Data were expressed as the mean ± SD or as number (%) for numerical variables. Results After a mean dose of 1.86 ± 0.49 ml (range: 1–3 ml) of isoamyl-2-cyanoacrylate was injected in each patient, hemostasis was achieved initially in 100% of patients and complete obliteration of GV in 100% of patients. Treatment-related complications occurred in 26.5% of patients (9/34), but all complications were transient and mild. Complications included ulceration at site of injection (8.8%), fever (2.9%), abdominal pain (5.8%), chest pain (5.8%), and transient dysphagia (2.9%). Only one (2.9%) patient died closed to the cyanoacrylate treatment during hospitalization owing to hepatic encephalopathy and hepatorenal syndrome type I. During mean follow-up of 11.9 + 5.2 months (range: 2 weeks–21 months), rebleeding occurred in 8.8% of our patients. Conclusion This study has demonstrated the efficacy and safety of endoscopic treatment of bleeding GV using isoamyl-2-cyanoacrylate injection with initial hemostasis and complete obliteration of GV with no serious complications and low risk of rebleeding and bleeding-related death.http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2019;volume=2;issue=1;spage=36;epage=41;aulast=Fouadcyanoacrylatesendoscopic variceal obliterationendoscopygastric variceshemostasisisoamyl-2-cyanoacrylateliver cirrhosis |
| spellingShingle | Tarek A Fouad El Saied E. Shabaan Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate Journal of Medicine in Scientific Research cyanoacrylates endoscopic variceal obliteration endoscopy gastric varices hemostasis isoamyl-2-cyanoacrylate liver cirrhosis |
| title | Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate |
| title_full | Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate |
| title_fullStr | Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate |
| title_full_unstemmed | Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate |
| title_short | Endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl-2-cyanoacrylate |
| title_sort | endoscopic treatment of acute gastric variceal bleeding in patients with cirrhosis using isoamyl 2 cyanoacrylate |
| topic | cyanoacrylates endoscopic variceal obliteration endoscopy gastric varices hemostasis isoamyl-2-cyanoacrylate liver cirrhosis |
| url | http://www.jmsr.eg.net/article.asp?issn=2537-091X;year=2019;volume=2;issue=1;spage=36;epage=41;aulast=Fouad |
| work_keys_str_mv | AT tarekafouad endoscopictreatmentofacutegastricvaricealbleedinginpatientswithcirrhosisusingisoamyl2cyanoacrylate AT elsaiedeshabaan endoscopictreatmentofacutegastricvaricealbleedinginpatientswithcirrhosisusingisoamyl2cyanoacrylate |