IngentaConnect Enbucrilate for gastric varices: extended experience in 92 patien...

Authors: CALDWELL, S. H.¹; HESPENHEIDE, E. E.¹; GREENWALD, B. D.²; NORTHUP, P. G.¹; PATRIE, J. T.³

Source: Alimentary Pharmacology & Therapeutics, Volume 26, Number 1, July 2007 , pp. 49-59(11)

Abstract:

Summary Aim

We assessed N-2-butyl-cyanoacrylate (enbucrilate) in 92 patients with gastric variceal bleeding under an FDA-approved investigation. These results extend our prior report of the first 44 patients. Method

Injection was performed with enbucrilate and ethiodol (1:1). Eighty patients had portal hypertension and 12 had splenic vein thrombosis. Results

In the portal hypertensive group, re-bleeding from gastric varices was seen in 4 of 80 (5%) from 0 to 72 h, 5 of 76 (6.5%) from > 72 h to 3 months and 9 of 51 (17%) from > 3 months to 1 year. Re-bleeding and survival were significantly related to the Child-Pugh class. In the splenic vein thrombosis group (n = 12), there was early rebleeding in 2 (17%) patients from 0 to 72 h, 1 (8%) from > 72 h to 3 months and none in the chronic phase (> 3 months to 1 year) although 1-year survival in this group was only 6 (50%) due to the underlying malignancy in most. Serious embolization was suspected in 2 patients (2%). Conclusion

Enbucrilate offers an important intervention in gastric variceal bleeding which should be further studied in the US. A randomized trial is warranted to compare this intervention to radiological therapy.

Document Type: Research article

DOI: 10.1111/j.1365-2036.2007.03351.x

Affiliations: 1: GI/Hepatology Division, Digestive Health Center of Excellence, University of Virginia Medical Center, Charlottesville, VA, USA 2: GI Division, University of Maryland Medical Center, Baltimore, MD, USA 3: The Department of Health Evaluation Sciences, University of Virginia, Charlottesville, VA, USA

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Enbucrilate for gastric varices: extended experience in 92 patients