Endoscopy 1995; 27(5): 349-354
DOI: 10.1055/s-2007-1005712
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Ethanolamine Oleate Versus Butyl Cyanoacrylate for Bleeding Gastric Varices: a Nonrandomized Study

K. Oho, T. Iwao, M. Sumino, A. Toyonaga, K. Tanikawa
  • Department of Medicine II, Division of Gastroenterology and Endoscopy, Kurume University School of Medicine, Kurume, Japan
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Abstract

Background and Study Aims: Sclerotherapy may be useful in patients with bleeding gastric varices. The aim of this study was to compare the effects of two sclerosants in these patients.

Patients and Methods: In a prospective nonrandomized trial, we performed single sclerotherapy for bleeding gastric varices using ethanolamine oleate (n = 24) or butyl cyanoacrylate (n = 29). The patients were followed for a mean of 14 months.

Results: The rate of initial hemostasis (no bleeding occurred for 48 hours after sclerotherapy) was significantly higher in the butyl cyanoacrylate group (93 %) than in the ethanolamine oleate group (67 %) (p = 0.014). The rate of initial hemostasis in cardiac variceal bleeding did not differ significantly between the ethanolamine oleate and butyl cyanoacrylate groups (83 % vs. 100 %, p = 0.140). In contrast, the hemostasis rate for fundal variceal bleeding was significantly higher in the butyl cyanoacrylate group than in the ethanolamine oleate group (88 % vs. 50 %, p = 0.023). Although the rebleeding rate did not differ between the two groups (30 % vs. 25 %, p = 0.921), the mortality rate was significantly higher in the ethanolamine oleate group (67 % vs. 38 %, p = 0.043). In addition, the incidence of complications in the butyl cyanoacrylate group was similar to that in the ethanolamine oleate group (46 % vs. 41 %, p = 0.745).

Conclusions: These results suggest that initial control of fundal varices is more difficult than it is with cardiac varices, but butyl cyanoacrylate is superior to ethanolamine oleate, and the survival advantage from butyl cyanoacrylate seems to be partially related to the increased early bleeding deaths in the ethanolamine oleate group.