Ultrasound endoscopy or titanium clip-assisted tissue glue injection versus balloon-occluded retrograde transvenous obliteration for gastric varices:a comparison study of the efficacy and safety based on network meta-analysis
10.3969/j.issn.1008-794X.2025.10.015
- VernacularTitle:超声内镜或钛夹辅助下组织胶注射与球囊阻塞逆行经静脉闭塞术治疗胃静脉曲张疗效及安全性比较——网状Meta分析
- Author:
Qingchen WANG
1
;
Hongbin ZHU
;
Yifu XIA
;
Chunqing ZHANG
Author Information
1. 250021 山东济南 山东第一医科大学附属省立医院消化内科
- Keywords:
cirrhosis;
gastric varices;
balloon-occluded retrograde transvenous obliteration;
endoscopic ultrasound;
titanium clip;
cyanoacrylate;
network meta-analysis
- From:
Journal of Interventional Radiology
2025;34(10):1116-1123
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the safety and efficacy of balloon-occluded retrograde transvenous obliteration(BRTO),endoscopic ultrasound(EUS)-guided coil embolization combined with endoscopic injection of cyanoacrylate,and titanium clip-assisted endoscopic cyanoacrylate injection(CLIP-ECI)in the treatment of gastric varices based on a network meta-analysis.Methods A computerized retrieval of randomized controlled trials(RCT)and retrospective studies concerning the"balloon-occluded retrograde transvenous obliteration""EUS-guided coil embolization combined with endoscopic injection of cyanoacrylate"and"titanium clip-assisted endoscopic cyanoacrylate injection"from the databases of PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang Medical Network,and CBM was conducted.The retrieval time period was from the establishment of the database to July 1,2024.Studies were selected based on inclusion and exclusion criteria,and data were processed using a random-effects model with STATA14.0 software for network meta-analysis.Results A total of 22 articles,including 7 RCTs and 15 retrospective studies,were included in this analysis,with a total sample size of 2 122 patients.The network meta-analysis showed that in terms of rebleeding prevention,the BRTO group(SUCRA 93.5)had the lowest rebleeding rate,followed by the EUS group(SUCRA 72.0);in terms of mortality,the CLIP-ECI group(SUCRA 82.1)had the lowest overall mortality,followed by the BRTO group(SUCRA 75.5);in terms of ectopic embolism rate,the BRTO group(SUCRA 68.7)had the smallest likelihood of ectopic embolism,while the ECI group(SUCRA 23.8)had the highest likelihood;in terms of gastric variceal eradication,the BRTO group(SUCRA 95.4)had the highest variceal eradication rate,followed by the EUS group(SUCRA 60.7).Conclusion Compared with endoscopic therapy,BRTOcan reduce the rebleeding rate of gastric varices and increase the eradication rate,with lower rates of ectopic embolization and mortality.Therefore,BRTO is an effective and safe means for the treatment of gastric varices.
