Clin Endosc.  2024 Sep;57(5):690-693. 10.5946/ce.2023.239.

Long-term surveillance of gastric varices after cyanoacrylate injection in patients with non-cirrhotic portal hypertension: is it worth the effort?

Affiliations
  • 1Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
  • 2Gastroenterology and Hepatology Unit, Stadtspital Zürich, Zürich, Switzerland


Figure

  • Fig. 1. (A) Individual patient timelines after initial gastric varices treatment and endoscopic ultrasound (EUS) confirmation of obliteration. (B) Cumulative survival (Kaplan-Meier estimates) without recurrent gastric variceal hemorrhage (GVH). Patients 2 and 3 had GVH during follow-up, despite EUS surveillance and treatment of recurrent varices. Patients 1 and 9 had a single repeat intervention whereas patients 4 to 8 did not have recurrent varices.


Reference

1. Mohan BP, Chandan S, Khan SR, et al. Efficacy and safety of endoscopic ultrasound-guided therapy versus direct endoscopic glue injection therapy for gastric varices: systematic review and meta-analysis. Endoscopy. 2020; 52:259–267.
2. Sarin SK, Lahoti D, Saxena SP, et al. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology. 1992; 16:1343–1349.
3. Garcia-Pagán JC, Barrufet M, Cardenas A, et al. Management of gastric varices. Clin Gastroenterol Hepatol. 2014; 12:919–928.
4. European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018; 69:406–460.
5. Gralnek IM, Camus Duboc M, Garcia-Pagan JC, et al. Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2022; 54:1094–1120.
6. Marques P, Maluf-Filho F, Kumar A, et al. Long-term outcomes of acute gastric variceal bleeding in 48 patients following treatment with cyanoacrylate. Dig Dis Sci. 2008; 53:544–550.
7. Choudhuri G, Chetri K, Bhat G, Alexander G, et al. Long-term efficacy and safety of N-butylcyanoacrylate in endoscopic treatment of gastric varices. Trop Gastroenterol. 2010; 31:155–164.
8. Spaander MC, Darwish Murad S, van Buuren HR, et al. Endoscopic treatment of esophagogastric variceal bleeding in patients with noncirrhotic extrahepatic portal vein thrombosis: a long-term follow-up study. Gastrointest Endosc. 2008; 67:821–827.
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr