| Theme |
Treatment for Portal Hypertension : Update |
| Title |
Endoscopic Therapy with Cyanoacrylate for Gastric Varices |
| Author |
Takuto Hikichi |
Department of Endoscopy, Fukushima Medical University Hospital |
| Author |
Katsutoshi Obara |
Department of Endoscopy, Fukushima Medical University Hospital |
| Author |
Atsushi Irisawa |
Department of Gastroenterology, Preparatory Office for Aizu Medical Center, Fukushima Medical University |
| Author |
Tadayuki Takagi |
Department of Gastroenterology and Rheumatology, Fukushima Medical University |
| Author |
Masaki Sato |
Department of Gastroenterology and Rheumatology, Fukushima Medical University |
| Author |
Hiromasa Ohira |
Department of Gastroenterology and Rheumatology, Fukushima Medical University |
| [ Summary ] |
Rupture of gastric varices (GV) is often life-threatening because of massive bleeding. After the introduction of cyanoacrylate (CA), it become accepted that endoscopic therapy using CA is the first-line choice for treating GV bleeding. When endoscopic therapy is chosen as an additional treatment after initial hemostasis, CA/ethanolamine oleate (EO) combined therapy is useful. In CA/EO combined therapy, it is possible to obstruct not only GV but also inflow veins.
Because large bulky GV and GV with red-color signs and/or erosion exhibit a high risk of bleeding, preventive treatments should be implemented using CA/EO combined therapy. This treatment is also useful in high risk GV cases. However, we must understand portal hemodynamics to perform appropriate endoscopic procedures with optimum CA concentrations. |