Percutaneous transhepatic variceal embolization with 2-Octyl.Cyanoacrylate versus endoscopic cyano- acrylate injection for treatment of gastric variceal bleeding

Abstract

Objective To compare the efficacy of a modified percutaneous transhepatic variceal em- bolization （FIVE） with 2-Octyl-Cyanoacrylate （2-OCA） and endoscopic variceal obturation （EVO） in pre- venting gastric variceal bleeding. Methods Seventy-seven patients with history of gastric variceal bleeding who underwent either EVO or PTVE were retrospectively reviewed. The rebleeding rate, survival rate and complications were compared between the two groups. Results EVO was performed in 45 patients ; PTVE was performed in 32 patients. During the follow-up （ 19. 78±7. 70 months in EVO group, vs. 21.53 ±8.56 months in PTVE group） , rebleeding occurred in 17 patients （37.78%） of EVO group, and in 4 patients （ 12. 5% ） of FTVE group （P =0. 028）. The cumulative rebleeding free rate for EVO was 75% , 59%, and 49% in 1,2, and 3 years, respectively; 93%, 84%, 84% for PTVE （P=0. 011）. There is no significant different in survival rate and the incidence of complications was similar in two groups. Conclusion Com- pared with EVO, PTVE with 2-OCA demonstrates advantage as an effective and safe method for gastric vail- ces. Key words: Gastric varices ; Embolization, therapeutic ; Tissue adhesives ; Hemorrhage