<b>Backgrounds/Aims:</b> Rebleeding of gastric varices (GVs) after endoscopic variceal obturation (EVO) can be fatal. This study was performed to evaluate the usefulness of computed tomography (CT) for the prediction of rebleeding after EVO GV bleeding. <b>Methods:</b> Patients who were treated with EVO for GV bleeding and underwent CT before and after EVO were included. CT images of the portal phase showing pretreatment GVs and feeding vessels, and nonenhanced images showing posttreatment cyanoacrylate impaction were reviewed. <b>Results:</b> Fifty-three patients were included. Their mean age was 60.6±11.6 years, and 40 patients (75.5%) were men. Alcoholic liver disease was the most frequent underlying liver disease (45.3%). Complete impaction of cyanoacrylate in GVs and feeding vessels were achieved in 40 (75.5%) and 24 (45.3%) of patients, respectively. During the follow-up, GV rebleeding occurred in nine patients, and the cumulative incidences of GV rebleeding at 3, 6, and 12 months were 11.8%, 18.9%, and 18.9%, respectively. The GV rebleeding rate did not differ significantly according to the complete cyanoacrylate impaction in the GV, while it differed significantly according to complete cyanoacrylate impaction in the feeding vessels. The cumulative incidences of GV rebleeding at 3, 6, and 12 months were 22.3%, 35.2%, and 35.2%, respectively, in patients with incomplete impaction in feeding vessels, and there was no rebleeding during the follow-up period in patients with complete impaction in the feeding vessels (p=0.002). <b>Conclusions:</b> Abdominal CT is useful in the evaluation of the treatment response after EVO for GV bleeding. Incomplete cyanoacrylate impaction in feeding vessels is a risk factor for GV rebleeding.
Keywords: Cyanoacrylates; Esophageal and gastric varices; Ethiodized oil; Tomography; X-ray computed.
Comparison of Modified Percutaneous Transhepatic Variceal Embolization and Endoscopic Cyanoacrylate Injection for Gastric Variceal RebleedingJ Wang et al. World J Gastroenterol 19 (5), 706-14. PMID 23430149.With extensive and permanent obliteration of gastric varices and its feeding veins, PTVE with 2-OCA is superior to endoscopic 2-OCA injection for preventing gastric varic …
Prognosis of Patients With Gastric Variceal Bleeding After Endoscopic Variceal Obturation According to the Type of VaricesHA Lee et al. Eur J Gastroenterol Hepatol 31 (2), 211-217. PMID 30300160.EVO was very effective in patients with GVB. GV recurrence and GV rebleeding were significantly lower in patients with GOV1 than in those with GOV2.
The Safety and Efficacy of Gastric Fundal Variceal Obliteration Using N-butyl-2-cyanoacrylate; The Experience of a Single Canadian Tertiary Care CentreMH Mosli et al. Saudi J Gastroenterol 19 (4), 152-9. PMID 23828744.NBCA injection of GV is a safe and successful therapeutic intervention. A minimum of three endoscopic sessions is required to significantly decrease the risk of bleeding/ …
Treatment Modalities for Bleeding Esophagogastric VaricesH Yoshida et al. J Nippon Med Sch 79 (1), 19-30. PMID 22398787. - ReviewBleeding from esophageal varices (EVs) or gastric varices (GVs) is a catastrophic complication of chronic liver disease. In this paper, we review the management of bleedi …
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