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Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices
04:09

Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices

Published on: June 13, 2025

Long-term follow-up of gastric variceal sclerotherapy: an eleven-year experience

S K Sarin1

  • 1Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India.

Gastrointestinal Endoscopy
|July 1, 1997
PubMed

Insights

Gastric variceal sclerotherapy effectively stops bleeding and obliterates varices, especially gastroesophageal varices type 1. Alternative treatments are needed for isolated gastric varices type 1 due to higher rebleeding rates.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Endoscopic interventions

Background:

  • Gastric variceal bleeding is a critical medical emergency.
  • Endoscopic management strategies for gastric varices remain debated.
  • Classification and targeted treatments for different gastric varice types are needed.

Purpose of the Study:

  • To evaluate the efficacy of gastric variceal sclerotherapy in managing bleeding and achieving obliteration.
  • To compare treatment outcomes across different classifications of gastric varices.
  • To identify patient groups that may benefit from alternative therapeutic approaches.

Main Methods:

  • Gastric varices were classified into gastroesophageal varices type 1 (GOV1), type 2 (GOV2), and isolated gastric varices type 1 (IGV1).
  • Sclerotherapy involved weekly paravariceal and intravariceal injections of absolute alcohol.
  • Outcomes assessed included acute bleeding control, variceal obliteration, rebleeding rates, and mortality.

Main Results:

  • Sclerotherapy arrested acute bleeding in 66.7% of emergency cases.
  • Overall variceal obliteration was achieved in 71.6% of patients undergoing elective sclerotherapy.
  • Obliteration rates were highest for GOV1 (94.4%), followed by GOV2 (70.4%), and lowest for IGV1 (41%).
  • Rebleeding rates were significantly higher for IGV1 (53%) compared to GOV1 (5.5%) and GOV2 (19%).

Conclusions:

  • Gastric variceal sclerotherapy is effective for arresting acute bleeding and achieving obliteration.
  • Treatment success is significantly higher for gastroesophageal varices (GOV1 and GOV2) than isolated gastric varices (IGV1).
  • Alternative therapies should be explored for patients with IGV1 due to poor sclerotherapy outcomes and high rebleeding risk.
Abstract

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