Related Experiment Video
Updated: Jun 8, 2026
Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
Published on: June 13, 2025
Undiluted N-butyl cyanoacrylate is safe and effective for gastric variceal bleeding
Ajay Kumar1, Siddharth Singh, Kaushal Madan
1Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Background:
Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension. N-butyl cyanoacrylate (NBC), mixed with lipiodol, has been shown to be effective in controlling bleeding, but is associated with the risk of distal embolization.
Objective:
To study the efficacy and safety of undiluted NBC in the management of gastric varices (GV).
Design:
Prospective cohort study.
Setting:
Single tertiary care center.
Patients:
170 consecutive patients with GV.
Intervention:
Standardized technique of undiluted NBC injection for management of GV.
Main Outcome Measurements:
Achievement of initial hemostasis, rate of rebleeding, procedure-related complications, and mortality.
Results:
GV were identified in 170 patients, 87 of whom were treated with 261 injections of undiluted NBC. Among 46 patients with active bleeding of GV, initial hemostasis was achieved in 84.8%. Rebleeding was seen in 23.4% patients over a mean follow-up of 16 months. No case of clinical distal embolization was seen. Large GV size, fundal location, and large esophageal variceal size were predictive of GV bleed. The mortality was 8.8% for all patients with GV; 10.3% for patients with GV treated with NBC, and 7.2% for those with GV not treated with NBC. Child-Pugh status was the only predictor of mortality.
Limitation:
Only 1 intervention group.
Conclusion:
Undiluted NBC is safe and effective in the management of gastric variceal bleeding.
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