Outcomes and Predictors of Rebleeding After 2-Octyl Cyanoacrylate Injection in Acute Gastric Variceal Hemorrhage

Badr Al-Bawardy, Emmanuel C. Gorospe, Atif Saleem, Navtej Singh Buttar, Louis M. Wong Kee Song

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND AND AIM:: Endoscopic injection of 2-octyl cyanoacrylate (2-OCA) is used on an off-label basis for gastric variceal hemorrhage (GVH) in the United States. We assessed the efficacy, safety, and predictors of rebleeding after gastric variceal obturation (GVO) with 2-OCA in patients with acute GVH. MATERIALS AND METHODS:: A retrospective analysis was performed of patients with GVH who underwent 2-OCA injection for GVO over a 15-year period. Rates of acute hemostasis, predictors of rebleeding, and cyanoacrylate-related adverse events were assessed. RESULTS:: A total of 95 patients (63 males, median age 59±14 y) were analyzed. Gastric varices were categorized as GOV-1 (3%), GOV-2 (61%), and isolated gastric varices type 1 (36%) per Sarin classification. Initial hemostasis was achieved in all patients. Successful GVO, defined as sustained hemostasis within a month after injection, was achieved in 87 (92%) patients. Failed GVO with in-hospital rebleeding was observed in 8 (8%) patients. On univariate analysis, only the model for end-stage liver disease score was associated with an increased risk of rebleeding (odds ratio 1.2; 95% confidence interval, 1.1-1.4; P

Original languageEnglish (US)
JournalJournal of Clinical Gastroenterology
DOIs
StateAccepted/In press - Feb 17 2016

Fingerprint

Stomach
Hemorrhage
Injections
Hemostasis
Esophageal and Gastric Varices
Sarin
Cyanoacrylates
End Stage Liver Disease
octyl 2-cyanoacrylate
Odds Ratio
Confidence Intervals
Safety

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Outcomes and Predictors of Rebleeding After 2-Octyl Cyanoacrylate Injection in Acute Gastric Variceal Hemorrhage. / Al-Bawardy, Badr; Gorospe, Emmanuel C.; Saleem, Atif; Buttar, Navtej Singh; Wong Kee Song, Louis M.

In: Journal of Clinical Gastroenterology, 17.02.2016.

Research output: Contribution to journalArticle

@article{7eb247b48b464a4f882620f510368225,
title = "Outcomes and Predictors of Rebleeding After 2-Octyl Cyanoacrylate Injection in Acute Gastric Variceal Hemorrhage",
abstract = "BACKGROUND AND AIM:: Endoscopic injection of 2-octyl cyanoacrylate (2-OCA) is used on an off-label basis for gastric variceal hemorrhage (GVH) in the United States. We assessed the efficacy, safety, and predictors of rebleeding after gastric variceal obturation (GVO) with 2-OCA in patients with acute GVH. MATERIALS AND METHODS:: A retrospective analysis was performed of patients with GVH who underwent 2-OCA injection for GVO over a 15-year period. Rates of acute hemostasis, predictors of rebleeding, and cyanoacrylate-related adverse events were assessed. RESULTS:: A total of 95 patients (63 males, median age 59±14 y) were analyzed. Gastric varices were categorized as GOV-1 (3{\%}), GOV-2 (61{\%}), and isolated gastric varices type 1 (36{\%}) per Sarin classification. Initial hemostasis was achieved in all patients. Successful GVO, defined as sustained hemostasis within a month after injection, was achieved in 87 (92{\%}) patients. Failed GVO with in-hospital rebleeding was observed in 8 (8{\%}) patients. On univariate analysis, only the model for end-stage liver disease score was associated with an increased risk of rebleeding (odds ratio 1.2; 95{\%} confidence interval, 1.1-1.4; P",
author = "Badr Al-Bawardy and Gorospe, {Emmanuel C.} and Atif Saleem and Buttar, {Navtej Singh} and {Wong Kee Song}, {Louis M.}",
year = "2016",
month = "2",
day = "17",
doi = "10.1097/MCG.0000000000000487",
language = "English (US)",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Outcomes and Predictors of Rebleeding After 2-Octyl Cyanoacrylate Injection in Acute Gastric Variceal Hemorrhage

AU - Al-Bawardy, Badr

AU - Gorospe, Emmanuel C.

AU - Saleem, Atif

AU - Buttar, Navtej Singh

AU - Wong Kee Song, Louis M.

PY - 2016/2/17

Y1 - 2016/2/17

N2 - BACKGROUND AND AIM:: Endoscopic injection of 2-octyl cyanoacrylate (2-OCA) is used on an off-label basis for gastric variceal hemorrhage (GVH) in the United States. We assessed the efficacy, safety, and predictors of rebleeding after gastric variceal obturation (GVO) with 2-OCA in patients with acute GVH. MATERIALS AND METHODS:: A retrospective analysis was performed of patients with GVH who underwent 2-OCA injection for GVO over a 15-year period. Rates of acute hemostasis, predictors of rebleeding, and cyanoacrylate-related adverse events were assessed. RESULTS:: A total of 95 patients (63 males, median age 59±14 y) were analyzed. Gastric varices were categorized as GOV-1 (3%), GOV-2 (61%), and isolated gastric varices type 1 (36%) per Sarin classification. Initial hemostasis was achieved in all patients. Successful GVO, defined as sustained hemostasis within a month after injection, was achieved in 87 (92%) patients. Failed GVO with in-hospital rebleeding was observed in 8 (8%) patients. On univariate analysis, only the model for end-stage liver disease score was associated with an increased risk of rebleeding (odds ratio 1.2; 95% confidence interval, 1.1-1.4; P

AB - BACKGROUND AND AIM:: Endoscopic injection of 2-octyl cyanoacrylate (2-OCA) is used on an off-label basis for gastric variceal hemorrhage (GVH) in the United States. We assessed the efficacy, safety, and predictors of rebleeding after gastric variceal obturation (GVO) with 2-OCA in patients with acute GVH. MATERIALS AND METHODS:: A retrospective analysis was performed of patients with GVH who underwent 2-OCA injection for GVO over a 15-year period. Rates of acute hemostasis, predictors of rebleeding, and cyanoacrylate-related adverse events were assessed. RESULTS:: A total of 95 patients (63 males, median age 59±14 y) were analyzed. Gastric varices were categorized as GOV-1 (3%), GOV-2 (61%), and isolated gastric varices type 1 (36%) per Sarin classification. Initial hemostasis was achieved in all patients. Successful GVO, defined as sustained hemostasis within a month after injection, was achieved in 87 (92%) patients. Failed GVO with in-hospital rebleeding was observed in 8 (8%) patients. On univariate analysis, only the model for end-stage liver disease score was associated with an increased risk of rebleeding (odds ratio 1.2; 95% confidence interval, 1.1-1.4; P

UR - http://www.scopus.com/inward/record.url?scp=84958794257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958794257&partnerID=8YFLogxK

U2 - 10.1097/MCG.0000000000000487

DO - 10.1097/MCG.0000000000000487

M3 - Article

C2 - 26890326

AN - SCOPUS:84958794257

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

ER -