Histoacryl is highly effective in controlling active bleeding of esophageal and gastric varices.
However, it is not known whether repeated histaoacryl injections are effective for long-term eradication of esophagogastric varices.
A team of Belgian doctors compared the efficacy and safety of endoscopic histoacryl injection with beta-blocker (propranolol) administration in the secondary prevention of esophagogastric variceal bleeding.
41 patients with primary bleeding from esophageal or gastric varices were included in the study.
Primary hemostasis was achieved with histoacryl obliteration of the varices.
Subsequently, the research team randomised patients to undergo complete histoacryl obliteration of the remaining varices with histoacryl or to recieve long-term propranolol administration for the prevention of rebleeding.
There was no significant difference in the incidence of early rebleeding between the 2 treatment groups. 5 of the 21 patients who underwent histoacryl injection and 3 of the 20 patients taking propanolol re-bled within the first 6 weeks.
There was also no significant difference in long-term rebleeding or mortality between the 2 treatment groups.
Complications, however, were significantly more likely in patients who underwent histoacryl variceal eradication.
10 out of 21 patients receiving histoacryl injections suffered adverse effects, compared with only 2 of the 20 patients receiving beta-blockers.
| Repeated injections of histoacryl are associated with more complications compared with beta-blocker administration, with similar results in terms of rebleeding rate and survival in the long term.|