Endoscopic Injection Sclerotherapy Assisted by Cyanoacrylate and Clips for Gastroesophageal Varices

Gastroesophageal variceal bleeding (GEVB) is the most common complication of liver cirrhosis and the leading cause of death in patients with liver cirrhosis. Traditional endoscopic sclerotherapy has been widely used for the treatment of variceal bleeding. However, it still has a high rate of rebleeding and may cause esophageal ulceration, stricture, or perforation. Here we present a sclerotherapy method, endoscopic injection sclerotherapy assisted by cyanoacrylate and clips (CISC), as a feasible and safe procedure for gastroesophageal varices (GEVs). The method uses clips to block the oral side (outflow vein) of GEVs, lauromacrogol to sclerose the main body of GEVs, and cyanoacrylate to occlude the puncture site at the anal side (inflow vein) of GEVs. A case involving a 47-year-old male patient with GEVB is presented to illustrate the CISC procedure. In this case, CISC was effective for the treatment of gastroesophageal variceal bleeding. We propose that CISC may be considered as a first option for clinical endoscopic hemostasis.