Endoscopic‐ultrasound‐guided coil and cyanoacrylate embolization for gastric varices and the roles of endoscopic Doppler and endosonographic varicealography in vascular targeting.

Objective: To report the results of endoscopic ultrasound‐guided injection of coils with cyanoacrylate (CYA) using a less‐expensive coil with an emphasis on the roles of Doppler and endosonographic varicealography (EV) in identifying the feeder vessel in gastric varix treatment. Methods: An observational, descriptive study with prospectively collected data. Patients with gastric varices (GV) were included and were treated by endoscopic ultrasound‐guided injection of CYA and a less‐expensive coil. Technical success, complete and immediate variceal obliteration, rebleeding, complication and survival rates were evaluated. Results: Thirty patients with GV with a mean age of 62 years (range: 44–76 years) were treated. Median number of coils used was 2 (range: 1–3), and median volume of CYA was 1.8 mL (1.2–2.4 mL). Technical success rate was 100%. EV technical success was observed in 26/30 patients. Complete variceal obliteration was observed in 96.6% of patients, and immediate disappearance of the varix was observed in 24 (80%) patients. The complication rate was 6.7%. Conclusions: Endoscopic‐ultrasound guidance for gastric varix treatment with the addition of EV and the use of a less‐expensive coil is a safe and effective technique that results in the immediate disappearance of GV after targeting the feeding vessel. [ABSTRACT FROM AUTHOR]