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Enbucrilate for gastric varices: extended experience in 92 patients
Author(s) -
CALDWELL S. H.,
HESPENHEIDE E. E.,
GREENWALD B. D.,
NORTHUP P. G.,
PATRIE J. T.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03351.x
Subject(s) - medicine , gastric varices , varices , malignancy , portal hypertension , portal vein thrombosis , gastroenterology , splenic vein , surgery , embolization , thrombosis , varix , cirrhosis
Summary Aim We assessed N‐2‐butyl‐cyanoacrylate (enbucrilate) in 92 patients with gastric variceal bleeding under an FDA‐approved investigation. These results extend our prior report of the first 44 patients. Method Injection was performed with enbucrilate and ethiodol (1:1). Eighty patients had portal hypertension and 12 had splenic vein thrombosis. Results In the portal hypertensive group, re‐bleeding from gastric varices was seen in 4 of 80 (5%) from 0 to 72 h, 5 of 76 (6.5%) from > 72 h to 3 months and 9 of 51 (17%) from > 3 months to 1 year. Re‐bleeding and survival were significantly related to the Child‐Pugh class. In the splenic vein thrombosis group ( n = 12), there was early rebleeding in 2 (17%) patients from 0 to 72 h, 1 (8%) from > 72 h to 3 months and none in the chronic phase (> 3 months to 1 year) although 1‐year survival in this group was only 6 (50%) due to the underlying malignancy in most. Serious embolization was suspected in 2 patients (2%). Conclusion Enbucrilate offers an important intervention in gastric variceal bleeding which should be further studied in the US. A randomized trial is warranted to compare this intervention to radiological therapy.