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• W2978665327 abstract "Purpose: Acute gastrointestinal bleeding from gastric variceal bleeding is associated with significant morbidity and mortality. Role of cyanoacrylate has been reported in several studies. We performed a systematic review to evaluate the effectiveness and safety of cyanoacrylate injection for treatment of acute gastric variceal bleed. Methods: Pubmed, Embase, CINHAL, the Cochrane Library and abstracts from major conference proceedings were searched for relevant articles (search date 6/12). Retrospective or prospective studies assessing the effectiveness and safety of cyanoacrylate injection for therapy of acute gastric variceal bleed in adult patients were included. All studies with sample size of 25 patients or greater were included. Data on the patient characteristics, etiology of liver disease, outcomes of the procedure (immediate control of bleeding, rate of rebleeding, failure of endoscopic therapy) and complications were extracted. Two reviewers independently extracted the data. Results: Nineteen studies met the inclusion criteria (N=1,217). The studies were performed in India, Korea, Spain, Brazil, Germany, Thailand, Japan, Egypt, USA, Canada, China, UK, Taiwan, Italy and Pakistan. Seven studies were prospective studies, and 12 were retrospective. Sample sizes ranged from 29-100 patients. The mean age of the patients ranged from 19-80 yrs. Etiology of liver disease was alcoholic or viral hepatitis in most of the studies. Hepatocellular carcinoma was present in 17-80% of patients (193pts, 7 studies). Severity of liver disease (Child-Pugh score) was as follows: A 13-40%, B 34-54%, C 18-53%. Grade of varices (Sarin classification) was as follows: GOV 1 10-67%, GOV 2 19-80%, IGV 1 2-44%, IG2 2-13%. The dose of the cyanoacrylate ranged from 0.5 to 1.5 ml. Dose of lipoidal used ranged from 0.5ml to 1.5 ml. The numbers of injections per session ranged from 1-5. In all studies, it was injected during the time of the procedure. Immediate control of bleeding was achieved in 82-100% of patients. Rebleeding occurred in 10-30 % of patients. Treatment failure occurred in 6-25% of cases. Eradication of the varices was achieved in 36-80%. Mean number of sessions to achieve eradication ranged from 1.3-2.7 sessions. Complications occurred in 4-35% of patients. These included fever, infectious causes, pulmonary embolism, post injection ulcers, cast extrusion, chest pain and thrombosis. Clogging of the injection needle was reported in 3 studies. Conclusion: Cyanoacrylate is a promising agent for control of acute gastric variceal bleeding. Further larger randomized studies are needed to assess its efficacy and safety." @default.
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• W2978665327 date "2012-10-01" @default.
• W2978665327 modified "2023-09-25" @default.
• W2978665327 title "Cyanoacrylate for Treatment of Acute Variceal Bleeding: A Systematic Review" @default.
• W2978665327 doi "https://doi.org/10.14309/00000434-201210001-01846" @default.
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