Endohepatology in clinical practice: EUS-guided cyanoacrylate embolisation of gastroesophageal varices supplied by the gastric coronary vein

OBJECTIVE: To investigate the safety and efficacy of treating gastroesophageal varices by gastric coronary vein puncture cyanoacrylate selective seal (PCSS) under endoscopic ultrasound. METHODS: Cirrhotic patients with esophagastric varices undergoing endotherapy for secondary prophylaxis in our centre were retrospectively included and analysed. The primary evaluation indicators were the eradication rate of varices and variceal rebleeding. The secondary evaluation indicator was reinterventions. RESULTS: A total of 46 patients were included in the study. All procedures were technically successful in all patients. Esophagastric varices were eradicated in 39 patients (92.86%) according to contrast-enhanced computed tomography re-examination within 1 month after the procedure. No symptoms or signs of cyanoacrylate embolisation related to the procedure were observed. Rebleeding occurred in two patients (4.76%) during a median follow-up period of 676 days (95% CI 665-688 days). CONCLUSION: PCSS enables optimal visualisation of gastroesophageal varices and their feeding vessels and precise delivery of cyanoacrylate embolisation. The technique demonstrates a satisfactory degree of both effectiveness and safety.