N-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate andhypertonic glucose with 72% chromated glycerin in gastricvarices

cyanoacrylate and a mixture of 72% chromated glycerinwith hypertonic glucose solution in management ofgastric varices.METHODS： Ninety patients with gastric varicespresented to Endoscopy Unit of Ain Shams UniversityHospital were included. They were randomly allocatedinto three groups; each group included 30 patients treatedwith intravariceal sclerosant injections in biweeklysessions till complete obturation of gastric varices;Group I （n-butyl-2-cyanoacrylate; Histoacryl？）, GroupII （iso-amyl-2-cyanoacrylate; Amcrylate？） and GroupIII （mixture of 72% chromated glycerin; Scleremo？with glucose solution 25%）. All the procedures wereperformed electively without active bleeding. Recruitedpatients were followed up for 3 mo.RESULTS： 26% of Scleremo group had bleeding duringpuncture vs 3.3% in each of the other two groups withsignificant difference, （P 〈 0.05）. None of Scleremogroup had needle obstruction vs 13.3% in each of theother two groups with no significant difference, （P 〉0.05）. Rebleeding occurred in 13.3% of Histoacryl andAmcrylate groups vs 0% in Scleremo group with nosignificant difference. The in hospital mortality was 6.6%in both Histoacryl and Amcrylate groups, while it was0% in Scleremo group with no significant difference. Inthe first and second sessions, the amount of Scleremoneeded for obturation was significantly high, while the amount of Histoacryl was significantly low. Scleremo was the less costly of the two treatments. CONCLUSION： All used sclerosant substances showed efficacy and success in management of gastric varices with no significant differences except in total amount,cost and bleeding during puncture.