Endoscopic Cyanoacrylate Injection with Post-injection Audible Doppler Assessment of Gastric Varices: A Single-Institution Experience.
Background and Aims: Gastric varices (GV) have higher rates of morbidity and mortality from hemorrhage than esophageal varices. Several studies have shown the safety and efficacy of cyanoacrylate (CA) injection for acute gastric variceal hemorrhage. We report data from our experience with CA injecti...
| Publicado en: | Digestive Diseases & Sciences Vol. 62; no. 11; pp. 3091 - 3100 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125824898&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125824898 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01632116 1VP jtl: Digestive Diseases & Sciences issn: 01632116 maglogo: N pubinfo: dt: Nov2017 vid: 62 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125824898 125824898 144077174 NLM28702754 125824898 10.1007/s10620-017-4671-2 NLM28702754 125824898 ppf: 3091 ppct: 9 formats: tig: atl: Endoscopic Cyanoacrylate Injection with Post-injection Audible Doppler Assessment of Gastric Varices: A Single-Institution Experience. aug: au: Catron, Tom Smallfield, George Kang, Le Sterling, Richard Siddiqui, Mohammad Catron, Tom D Smallfield, George B Sterling, Richard K Siddiqui, Mohammad S affil: Tinsley Harrison Internal Medicine Residency Training Program , University of Alabama at Birmingham , 1720 2nd Ave South Birmingham 35233 USA sug: subj: Gastrointestinal Hemorrhage Therapy Esophageal and Gastric Varices Therapy Hemostasis, Endoscopic Methods Gastrointestinal Hemorrhage Endoscopy, Gastrointestinal Methods Esophageal and Gastric Varices Ultrasonography, Doppler Recurrence Male Gastrointestinal Hemorrhage Etiology Kaplan-Meier Estimator Virginia Time Factors Predictive Value of Tests Endoscopy, Gastrointestinal Adverse Effects Esophageal and Gastric Varices Mortality Prognosis Treatment Outcomes Female Hemostasis, Endoscopic Mortality Esophageal and Gastric Varices Complications Endoscopy, Gastrointestinal Mortality Aged Risk Factors Middle Age Gastrointestinal Hemorrhage Mortality Hemostasis, Endoscopic Adverse Effects Retrospective Design Injections Human Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Background and Aims: Gastric varices (GV) have higher rates of morbidity and mortality from hemorrhage than esophageal varices. Several studies have shown the safety and efficacy of cyanoacrylate (CA) injection for acute gastric variceal hemorrhage. We report data from our experience with CA injection for GV before and after routine use of post-injection audible Doppler assessment (ADA) for GV obturation and describe long-term outcomes after this therapy.Methods: We retrospectively identified patients who had documented GV, underwent CA injection, and had at least 2 weeks of follow-up. We recorded and analyzed the survival and rebleeding rates with patient demographics, clinical data, and endoscopy findings between two groups of patients who were categorized by CA injection prior to and after inception of the ADA technique.Results: Seventy-one patients were identified with 16 patients analyzed in a group where ADA was not used (Pre-ADA) and 55 analyzed where ADA was used (Post-ADA). No rebleeding events were observed within 1 week of initial CA injection. No embolic events were reported after any initial CA injection within 4 weeks. The rate of bleed-free survival at 1 year was 69.6% in the Pre-ADA group and 85.8% in the Post-ADA without statistical significance. The all-cause 1-year mortality was 13.8% in the Pre-ADA group and 10.7% in the Post-ADA group without statistical significance.Conclusions: ADA of CA-injected GV does not appear to significantly affect adverse events or clinical outcomes; however, our findings are limited by small sample size and cohort proportions allowing for significant type II statistical error. Further prospective investigation is required to determine the impact of ADA on clinical outcomes after GV obturation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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