Percutaneous transhepatic variceal embolization with cyanoacrylate versus endoscopic ligation in management of esophageal variceal bleeding

Shu Bian; Chunqing Zhang; Fuli Liu; Feng Liu; Kai Feng; Hongwei XU; Qiang Zhu; Junyong Zhang; Jiyong Liu

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Percutaneous transhepatic variceal embolization with cyanoacrylate versus endoscopic ligation in management of esophageal variceal bleeding

VernacularTitle:经皮经肝组织胶栓塞治疗食管静脉曲张与内镜下套扎治疗的疗效比较
Author: Shu BIAN ; Chunqing ZHANG ; Fuli LIU ; Feng LIU ; Kai FENG ; Hongwei XU ; Qiang ZHU ; Junyong ZHANG ; Jiyong LIU
Publication Type:Journal Article
Keywords: Esophageal varices; Percutaneous transhepatic variceal embolization; TH glue; Endoscopy variceal ligation
From: Chinese Journal of Digestive Endoscopy 2009;26(3):115-119
CountryChina
Language:Chinese
Abstract: Objective To compare the therapeutic effect of percutaneous transhepatic variceal em-bolization (PTVE) with Cyanoacrylate(TH glue) with that of endoscopic variceal ligatien (EVL) in the treatment of esophageal varlceal bleeding. Methods In this prospective randomized controlled trial, cirrhot-ic patients with acute or recent esophageal variceal bleeding were assigned randomly to PTVE (n = 52) or EVL (n=50) groups. Variants including upper gastrointestinal (UGI) re-bleeding, esophageal variceal re-bleeding, relapse of esophageal variees and survival were evaluated. Results During the follow-up (median 24 and 25 months in the PTVE and EVL groups, respectively), UGI re-bleeding developed in 8 patients (15. 4%) in PTVE group and in 21 (42%) in EVL group (X2 =8. 87, P=0. 005). Recurrent esophageal varices bleeding occurred in 3 patients (5. 8%) in FIVE group and 12 (24%) in EVL group (X2 =5.38, P =0. 012, relative risk 0. 24, 95% confidence interval 0. 05 -0. 74). Reccurent rates of esophageal vari-ces in two groups were 17.3% (9/52) and 52% (26/50), respectively (X2 =13.61, P<0.001). There was no significant difference in survival rate between two groups (X2 = 3.30, P = 0. 054). Conclusion With sufficient embolization of lower esophageal and pefi-esophngeal varices and/or the cardial submucosal and perforating vessels, PTVE was more effective than EVL in the management of esophageal varices recur-rence and re-bleeding.