Gastric variceal
bleeding is associated with significant morbidity and mortality in patients with
portal hypertension and
cirrhosis. Options are limited for patients who are not candidates for transjugular intrahepatic
portosystemic shunts (
TIPS).
Cyanoacrylate injections have been reported to be efficacious in previous case series. The aim of this retrospective study was to report our single-center experience with the safety and efficacy of 2-octyl-cyanoacrylate in patients who were not
TIPS candidates. Electronic medical records were reviewed for 16 patients who underwent a total of 18 esophagogastroduodenoscopies for acute gastric or duodenal variceal
bleeding and secondary prophylaxis of
gastric varices; 14 patients had
cirrhosis with an average Model for
End-Stage Liver Disease score of 16, and 2 patients had noncirrhotic
portal hypertension. Primary endpoints of the study included early and delayed rebleeding rate, complications, and death or
liver transplantation. The rebleeding rate (early or delayed) was 7%, and no complications were found. One death was reported (unrelated to the procedure). In conclusion, 2-octyl-cyanoacrylate is a safe and effective alternative for non-
TIPS candidates who present with acute gastric variceal
bleeding given its low rebleeding and complication rate.