Efficacy and safety of EUS-guided coil embolization in combination with cyanoacrylate injection versus conventional endoscopic cyanoacrylate injection in the treatment of gastric varices with spontaneous portosystemic shunts  

作　　者：Dawei Chen Sunya Fu Ruiwei Shen 

机构地区：[1]Department of Gastroenterology,Ningbo Medical Center Lihuili Hospital,Ningbo,Zhejiang,P.R.China [2]Department of Radiology,Ningbo Medical Center Lihuili Hospital,Ningbo,Zhejiang,P.R.China

出　　处：《Gastroenterology Report》2024年第1期155-161,共7页胃肠病学报道(英文)

基　　金：supported by Medical Science and Technology Project of Zhejiang Provincial Health Commission(No.2020KY863);Natural Science Foundation of Ningbo(No.2019A610222).

摘　　要：Background:Gastric varices(GV)with spontaneous portosystemic shunts(SPSS)pose considerable risks and challenges for administering endoscopic cyanoacrylate(CYA)injection.This study aimed to evaluate the efficacy and safety of EUS-guided coil embolization in combination with CYA injection compared to conventional endoscopic CYA injection for managing GV with SPSS.Methods:This retrospective analysis included patients with SPSS treated with either EUS-guided coil embolization in combination with CYA injection or conventional CYA injection for gastric variceal bleeding at Ningbo Medical Center Lihuili Hospital(Zhejiang,China)between January 2018 and March 2023.Patient demographics,procedural details,and follow-up results were reviewed.Results:The study evaluated 57 patients:21 in the combined treatment group undergoing EUS-guided coil embolization in combination with CYA injection and 36 in the conventional group receiving conventional endoscopic CYA injection.Both cohorts achieved a 100%technical success rate.The mean volume of CYA used was significantly lower in the combined group(1.64±0.67mL)than in the conventional group(2.38±0.72mL;P<0.001).Early GV rebleeding rates did not differ significantly between the groups;in contrast,the combined treatment group exhibited a considerably lower incidence of late GV rebleeding than the conventional group(4.8%vs 27.8%,P=0.041).Conclusions:EUS-guided coil embolization in combination with CYA injection demonstrated superiority over conventional endoscopic CYA injection in reducing late GV rebleeding in treating GV with SPSS.

关 键 词：EUS coil embolization gastric varices CYANOACRYLATE spontaneous portosystemic shunts 

分 类 号：R73[医药卫生—肿瘤]