A pilot study of 2-octyl cyanoacrylate injection for treatment of gastric fundal varices in humans

Gastrointest Endosc. 2004 Apr;59(4):553-8. doi: 10.1016/s0016-5107(03)02865-7.


Background: N-butyl cyanoacrylate injection has been shown to be effective and safe for the endoscopic treatment of gastric varices. N-butyl cyanoacrylate is not available in the United States, but use of a similar agent, 2-octyl cyanoacrylate, recently was approved for skin closure. This pilot study prospectively evaluated the efficacy and safety of 2-octyl cyanoacrylate injection for treatment of gastric fundal varices.

Methods: Twenty-five patients with large gastric fundal varices with either stigmata of recent hemorrhage, a history of bleeding, or high-risk varices underwent intravariceal injection of undiluted 2-octyl cyanoacrylate. The end points for this study were cessation of active bleeding, successful obliteration of visible varices, and prevention of bleeding.

Results: Within 2 weeks of treatment, 52% of patients had a history of significant variceal bleeding, and 12% had active gastric variceal bleeding at the time of injection. The rate of immediate hemostasis was 100%. Gastric variceal bleeding recurred in 4% of patients (mean follow-up 11 months). The overall mortality rate was 12%; the bleeding-related mortality rate was 4%.

Conclusions: Injection of 2-octyl cyanoacrylate appears to be efficacious and safe for both prevention and control of gastric variceal hemorrhage. Larger studies are required to further establish the use of 2-octyl cyanoacrylate for treatment of gastric fundal varices.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cyanoacrylates / administration & dosage*
  • Embolization, Therapeutic / methods*
  • Endoscopy, Gastrointestinal
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / therapy*
  • Female
  • Gastric Fundus
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Sclerotherapy / methods*
  • Tissue Adhesives / administration & dosage*


  • Cyanoacrylates
  • Tissue Adhesives
  • octyl 2-cyanoacrylate