P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER?
Introduction and Objectives: Gastric varices affect approximately 20% of patients with portal hypertension; bleeding appears in 50-80%, with a mortality of 45%. There are two therapeutic options, cyanoacrylate and TIPS. The latter, due to its complexity, is limited. Cyanoacrylate is a more accessibl...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-03-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268123000741 |
| _version_ | 1797862169340018688 |
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| author | Aldo Carvajal Jorge Vargas Ana Madrigal Carolina Gutierrez Manfred Aguilar Marlon Rojas Luis Arguedas Pablo Cortes Francisco Vargas Karina Hidalgo Esteban Cob Adrian Gonzalez Francisco Hevia |
| author_facet | Aldo Carvajal Jorge Vargas Ana Madrigal Carolina Gutierrez Manfred Aguilar Marlon Rojas Luis Arguedas Pablo Cortes Francisco Vargas Karina Hidalgo Esteban Cob Adrian Gonzalez Francisco Hevia |
| author_sort | Aldo Carvajal |
| collection | DOAJ |
| description | Introduction and Objectives: Gastric varices affect approximately 20% of patients with portal hypertension; bleeding appears in 50-80%, with a mortality of 45%. There are two therapeutic options, cyanoacrylate and TIPS. The latter, due to its complexity, is limited. Cyanoacrylate is a more accessible technique, which can be performed conventionally by upper endoscopy (EGD) with direct visualization of the varices or guided by endoscopic ultrasound (EUS). This study aimed to compare the EUS-guided coil plus cyanoacrylate vs. the conventional technique of injection of cyanoacrylate in the management of acute gastric variceal bleeding. Materials and Methods: Twenty-three cases of acute gastric variceal bleeding that received cyanoacrylate either by EUS-guided or conventional technique due to active or recent bleeding were analyzed, assessing their ability to stop it and the presence of bleeding at the same admission. Results: Two groups were similar; 10 patients were male and 13 female. The type of gastric varices found was GOV1 in 12 patients (52.1%), GOV2 in 8 patients (34.7%) and in 3 patients (13.2%) both types were documented. At the time of EGD, 21.7% had active bleeding and bleeding was successfully controlled in all patients. There was one case of re-bleeding in the group of conventional cyanoacrylate technique that was controlled with EUS-guided embolization. The average number of injections was lower with EUS-guided therapy. Conclusions: Cyanoacrylate is essential in the approach to acute bleeding from gastric varices. The EUS method seems to be safer. However, it requires training in the EUS, in addition to being more expensive. In bleeding without being able to visualize gastric varices veins by direct visualization, the EUS is the best option. Any endoscopy unit that handles digestive bleeding requires personnel and equipment trained to have both techniques. |
| first_indexed | 2024-04-09T22:16:00Z |
| format | Article |
| id | doaj.art-3cb914e982b34da58258611e7887ae8e |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-09T22:16:00Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-3cb914e982b34da58258611e7887ae8e2023-03-23T04:34:13ZengElsevierAnnals of Hepatology1665-26812023-03-0128100970P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER?Aldo Carvajal0Jorge Vargas1Ana Madrigal2Carolina Gutierrez3Manfred Aguilar4Marlon Rojas5Luis Arguedas6Pablo Cortes7Francisco Vargas8Karina Hidalgo9Esteban Cob10Adrian Gonzalez11Francisco Hevia12University of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaUniversity of Costa Rica, San Juan de Dios Hospital, Costa Rican Social Security Foundation. San Jose, Costa RicaIntroduction and Objectives: Gastric varices affect approximately 20% of patients with portal hypertension; bleeding appears in 50-80%, with a mortality of 45%. There are two therapeutic options, cyanoacrylate and TIPS. The latter, due to its complexity, is limited. Cyanoacrylate is a more accessible technique, which can be performed conventionally by upper endoscopy (EGD) with direct visualization of the varices or guided by endoscopic ultrasound (EUS). This study aimed to compare the EUS-guided coil plus cyanoacrylate vs. the conventional technique of injection of cyanoacrylate in the management of acute gastric variceal bleeding. Materials and Methods: Twenty-three cases of acute gastric variceal bleeding that received cyanoacrylate either by EUS-guided or conventional technique due to active or recent bleeding were analyzed, assessing their ability to stop it and the presence of bleeding at the same admission. Results: Two groups were similar; 10 patients were male and 13 female. The type of gastric varices found was GOV1 in 12 patients (52.1%), GOV2 in 8 patients (34.7%) and in 3 patients (13.2%) both types were documented. At the time of EGD, 21.7% had active bleeding and bleeding was successfully controlled in all patients. There was one case of re-bleeding in the group of conventional cyanoacrylate technique that was controlled with EUS-guided embolization. The average number of injections was lower with EUS-guided therapy. Conclusions: Cyanoacrylate is essential in the approach to acute bleeding from gastric varices. The EUS method seems to be safer. However, it requires training in the EUS, in addition to being more expensive. In bleeding without being able to visualize gastric varices veins by direct visualization, the EUS is the best option. Any endoscopy unit that handles digestive bleeding requires personnel and equipment trained to have both techniques.http://www.sciencedirect.com/science/article/pii/S1665268123000741 |
| spellingShingle | Aldo Carvajal Jorge Vargas Ana Madrigal Carolina Gutierrez Manfred Aguilar Marlon Rojas Luis Arguedas Pablo Cortes Francisco Vargas Karina Hidalgo Esteban Cob Adrian Gonzalez Francisco Hevia P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? Annals of Hepatology |
| title | P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? |
| title_full | P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? |
| title_fullStr | P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? |
| title_full_unstemmed | P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? |
| title_short | P- 75 COMPARISON OF EUS-GUIDED COIL PLUS CYANOACRYLATE VS CONVENTIONAL CYANOACRYLATE TECHNIQUE IN THE MANAGEMENT OF ACUTE GASTRIC VARICEAL BLEEDING. WHICH ONE IS BETTER? |
| title_sort | p 75 comparison of eus guided coil plus cyanoacrylate vs conventional cyanoacrylate technique in the management of acute gastric variceal bleeding which one is better |
| url | http://www.sciencedirect.com/science/article/pii/S1665268123000741 |
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