Long-term outcomes of acute gastric variceal bleeding in 48 patients following treatment with cyanoacrylate

Dig Dis Sci. 2008 Feb;53(2):544-50. doi: 10.1007/s10620-007-9882-5. Epub 2007 Jun 28.


Objectives: (1) Study the effectiveness of intravariceal injection of n-butyl-2-cyanoacrylate to treat acute gastric variceal (GV) bleeding and (2) study the impact of the type of GV and hepatic function on endoscopic hemostasis and mortality outcomes.

Methods: Fourty-eight patients with acute GV bleeding underwent intravariceal injection of n-butyl-2-cyanoacrylate and were followed until death or study conclusion (12-52 months).

Results: Primary hemostasis (no re-bleeding within 48 h) was accomplished in 42 patients (87.5%). Appearance of the bleeding site at the time of initial endoscopy, grade of cirrhosis and location of GV were not significant predictors of immediate hemostasis. Early re-bleeding (48 h to 6 weeks) occurred in 20.5% of patients and late re-bleeding (beyond 6 weeks) in 20.5% of patients. While the Child-Pugh score was predictive of re-bleeding and mortality, the type of GV and stigmata at initial endoscopy were not significant predictors of re-bleeding and mortality. Over a mean follow-up of 18 months, mortality rates were 43.9% and bleeding was the commonest cause of death.

Conclusion: Endoscopic injection of n-butyl-2-cyanoacrylate is effective and safe for treating bleeding GV. Patients with poor hepatic function are at higher risk of re-bleeding and death after acute gastric variceal bleed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Enbucrilate / analogs & derivatives*
  • Enbucrilate / therapeutic use
  • Esophageal and Gastric Varices / drug therapy*
  • Esophageal and Gastric Varices / mortality
  • Esophageal and Gastric Varices / physiopathology
  • Female
  • Gastrointestinal Hemorrhage / drug therapy*
  • Gastrointestinal Hemorrhage / mortality
  • Gastrointestinal Hemorrhage / physiopathology
  • Hemostasis, Endoscopic*
  • Humans
  • Liver / physiopathology
  • Male
  • Middle Aged
  • Tissue Adhesives / therapeutic use*
  • Treatment Outcome


  • Tissue Adhesives
  • Enbucrilate