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Endoscopic‐ultrasound‐guided coil and cyanoacrylate embolization for gastric varices and the roles of endoscopic Doppler and endosonographic varicealography in vascular targeting
Author(s) -
RoblesMedranda Carlos,
Valero Manuel,
Nebel Joao Autran,
Britto Junior Sylon Ribeiro,
PugaTejada Miguel,
Ospina Jesenia,
MuñozJurado Guillermo,
PitangaLukashok Hannah
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13305
Subject(s) - medicine , varix , cyanoacrylate , endoscopic ultrasound , gastric varices , varices , complication , surgery , embolization , ultrasound , radiology , endoscopy , chemistry , cirrhosis , adhesive , organic chemistry , layer (electronics)
Objective To report the results of endoscopic ultrasound‐guided injection of coils with cyanoacrylate (CYA) using a less‐expensive coil with an emphasis on the roles of Doppler and endosonographic varicealography (EV) in identifying the feeder vessel in gastric varix treatment. Methods An observational, descriptive study with prospectively collected data. Patients with gastric varices (GV) were included and were treated by endoscopic ultrasound‐guided injection of CYA and a less‐expensive coil. Technical success, complete and immediate variceal obliteration, rebleeding, complication and survival rates were evaluated. Results Thirty patients with GV with a mean age of 62 years (range: 44–76 years) were treated. Median number of coils used was 2 (range: 1–3), and median volume of CYA was 1.8 mL (1.2–2.4 mL). Technical success rate was 100%. EV technical success was observed in 26/30 patients. Complete variceal obliteration was observed in 96.6% of patients, and immediate disappearance of the varix was observed in 24 (80%) patients. The complication rate was 6.7%. Conclusions Endoscopic‐ultrasound guidance for gastric varix treatment with the addition of EV and the use of a less‐expensive coil is a safe and effective technique that results in the immediate disappearance of GV after targeting the feeding vessel.