Endoscopic Cyanoacrylate Injection for the Treatment of Bleeding Gastric Varices: The First Iranian Series

Background: Gastric varices are a major cause of gastrointestinal bleeding and death in patients with portal hypertension. N-butyl-2-cyanoacrylate injection is a new method for controlling bleeding gastric varices. This study aims to investigate the prognosis and complications of cyanoacrylate therapy for bleeding gastric varices. Methods: We conducted a prospective study between May 2009 and January 2010 at our center affiliated with the Shiraz University of Medical Sciences, Shiraz, Iran. All patients with gastric variceal bleeding were enrolled in the study. N-butyl-2-cyanoacrylate injection was performed for treatment of the bleeding, and patients underwent monthly endoscopies to determine the outcomes. Results: There were 13 patients with portal hypertension and gastric variceal bleeding included in the study. Initial hemostasis was obtained in all patients but more than one injection was needed in seven patients. Two patients developed re-bleeding and two died of advanced cirrhosis and other accompanying diseases. Conclusion: No major complications were observed after treatment with N-butyl-2-cyanoacrylate. This method can be safely used in treatment of gastric variceal bleeding.