Injection of Cyanoacrylate+Lipiodol vs Cyanoacrylate+Lauromacrogol in Gastric Varices

Gastroesophageal variceal bleeding is known as one of the most frequent death causes of patients with portal hypertension. When a patient has a bleeding episode, if no further prophylactic treatments is given, it's very likely that he/she will develop another rebleeding event in the future and maybe a terminal event. Gastric varices occur in 18-70% of patients with portal hypertension, which appear to be more severe, to require more transfusion and to have a higher mortality rate than esophageal variceal bleeding, with a high rate of rebleeding(38-89%). It has been recommended to use endoscopic cyanoacrylate injection as the first line treatment for hemostasis and secondary prophylaxis for gastric varices by general consensus. However, the efficacy and prevalence of complications between mixture of cyanoacrylate + lipiodol and cyanoacrylate + lauromacrogol have not yet been explored and reported. We conducted this study to evaluate the effect of endoscopic injection of a mixture of cyanoacrylate and lipiodol versus cyanoacrylate and lauromacrogol in gastric varices.

Inclusion criteria

• Patients presented to our hospital with acute gastric variceal bleeding, with or without liver cirrhosis.
• The age of the patients range from 18 to 80 years old.

Exclusion criteria

• Patients who have contraindications for cyanoacrylate, lipiodol or lauromacrogol therapy.
• Patients who have abnormal portosystemic shunt according to the imaging results.
• Patients who have no previous upper gastrointestinal bleeding history.
• Patients who have multiple endoscopic treatments for esophagogastric varices before.