Korean J Gastrointest Endosc.  2001 Aug;23(2):69-75.

Efficacy of N-Butyl 2-Cyanoacrylate Injection Therapy for Gastric Variceal Bleeding

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of n-butyl 2-cyanoacrylate injection therapy for gastric variceal bleeding and to find out the factors related to clinical outcome.
METHODS
Sixty-seven patients treated with n-butyl 2-cyanoacrylate injection therapy for gastric variceal bleeding were retrospectively reviewed.
RESULTS
Initial hemostasis was achieved in all 12 patients. Success of therapy was achieved in 88% of the patients. A stepwise logistic regression analysis including age, sex, cause of cirrhosis, Child-Pugh class, variceal form, bleeding site, initial hemoglobin, and presence of hepatocellular carcinoma as variables indicated that only the Child-Pugh class was an independent predictive factor of treatment failure. Rebleeding occurred in 19% of the patients during the 4 weeks after therapy. The cumulative probability of 4-week remaining free of rebleeding was significantly higher in Child-Pugh A and B than in Child-Pugh C. Mortality at 4 weeks was 15%. The Child-Pugh class and the presence of hepatocellular carcinoma were the independent predictive factors of mortality at 4 weeks.
CONCLUSIONS
N-butyl 2-cyanoacrylate injection therapy is highly effective in the management of bleeding from gastric varices. Child-Pugh class is an important predictive factor of treatment failure, rebleeding, and survival after the therapy.

Keyword

Gastric varix; Bleeding; N-butyl 2-cyanoacrylate

MeSH Terms

Carcinoma, Hepatocellular
Esophageal and Gastric Varices*
Fibrosis
Hemorrhage
Hemostasis
Humans
Logistic Models
Mortality
Retrospective Studies
Treatment Failure
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