EUS‐Guided Cyanoacrylate Injection With Balloon‐Compression Sclerotherapy Versus Band Ligation for Gastroesophageal Varices: A Randomized Trial

{"BACKGROUND":[0],"AND":[1],"OBJECTIVES:":[2],"Gastroesophageal":[3],"varices":[4,29,87],"(GOV)":[5],"is":[6],"a":[7],"life-threatening":[8],"complication":[9],"of":[10,113],"portal":[11],"hypertension.":[12],"Endoscopic":[13],"ultrasound-guided":[14],"cyanoacrylate":[15],"injection":[16,40],"(EUS-CYA)":[17],"improves":[18,212],"gastric":[19,86],"variceal":[20,48,172,214],"treatment,":[21],"but":[22],"the":[23,133,139],"optimal":[24],"strategy":[25],"for":[26,85,95,104,148],"concomitant":[27],"esophageal":[28,171,213],"(EV)":[30],"remains":[31],"unclear.":[32],"We":[33],"compared":[34,220],"EUS-CYA":[35,44,67,74,207,222],"combined":[36,45,110,208],"with":[37,46,61,209,221,225],"balloon-compression":[38],"endoscopic":[39,47],"sclerotherapy":[41],"(bc-EIS)":[42],"versus":[43,136,162],"ligation":[49],"(EVL).":[50],"METHODS:":[51],"Single-center":[52],"randomized":[53],"controlled":[54],"trial":[55],"(July":[56],"2022-June":[57],"2025).":[58],"Cirrhotic":[59],"patients":[60],"GOV":[62],"were":[63],"assigned":[64],"1:1":[65],"to":[66],"+":[68,75,223],"bc-EIS":[69,90,134,149,210],"(n":[70,77],"=":[71,78,165,178,184],"62)":[72],"or":[73,98,197],"EVL":[76,99,140],"62).":[79],"All":[80],"received":[81],"EUS-guided":[82],"\\"sandwich":[83],"technique\\"":[84],"(GV).":[88],"Then,":[89],"(polidocanol":[91],"under":[92],"balloon":[93],"compression":[94],"10":[96,175],"min)":[97],"(spiral":[100],"ligation)":[101],"was":[102,109],"performed":[103],"EV.":[105],"The":[106],"primary":[107],"endpoint":[108],"eradication":[111,215],"rate":[112],"both":[114,127],"GV":[115,122],"and":[116,180,216],"EV":[117,129],"at":[118],"6":[119],"months.":[120],"RESULTS:":[121],"final":[123],"eradication:":[124,130],"100%":[125,131],"in":[126,132,138,189],"groups.":[128],"group":[135,141],"82.3%":[137],"(p":[142,164],"<":[143,158],"0.001).":[144,159],"Fewer":[145],"sessions":[146,219],"needed":[147],"(1.4":[150],"±":[151,155],"0.6":[152],"vs.":[153,195,200],"2.1":[154],"1.1,":[156],"p":[157],"Rebleeding:":[160],"9.7%":[161],"21.0%":[163],"0.081).":[166],"Independent":[167],"rebleeding":[168],"risk":[169],"factors:":[170],"diameter":[173],">":[174],"mm":[176],"(HR":[177,183],"6.98)":[179],"prior":[181],"bleeding":[182],"4.57).":[185],"No":[186,202],"significant":[187],"differences":[188],"hemostasis":[190],"(100%":[191],"both),":[192],"complications":[193],"(14.5%":[194],"17.7%),":[196],"recurrence":[198],"(0":[199],"3.2%).":[201],"severe":[203],"adverse":[204],"events.":[205],"CONCLUSION:":[206],"significantly":[211],"reduces":[217],"treatment":[218],"EVL,":[224],"comparable":[226],"safety.":[227],"TRIAL":[228],"REGISTRATION:":[229],"ChiCTR2000039974.":[230]}

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Publication Details

Journal
Journal of Gastroenterology and Hepatology
Published
2026-09-17
DOI
https://doi.org/10.1111/jgh.70715
Primary Topic
Liver Disease and Transplantation
Type
article
Field-Weighted Citation Impact
0.00

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article

EUS‐Guided Cyanoacrylate Injection With Balloon‐Compression Sclerotherapy Versus Band Ligation for Gastroesophageal Varices: A Randomized Trial

Derun Kong, Yuxin Liao, Zhihong Wang, Xuerong Cheng et al.
Journal of Gastroenterology and Hepatology
Liver Disease and Transplantation
article

EUS‐Guided Cyanoacrylate Injection With Balloon‐Compression Sclerotherapy Versus Band Ligation for Gastroesophageal Varices: A Randomized Trial

Derun Kong, Yuxin Liao, Zhihong Wang, Xuerong Cheng, Xu Yang
article en

Abstract

BACKGROUND AND OBJECTIVES: Gastroesophageal varices (GOV) is a life-threatening complication of portal hypertension. Endoscopic ultrasound-guided cyanoacrylate injection (EUS-CYA) improves gastric variceal treatment, but the optimal strategy for concomitant esophageal varices (EV) remains unclear. We compared EUS-CYA combined with balloon-compression endoscopic injection sclerotherapy (bc-EIS) versus EUS-CYA combined with endoscopic variceal ligation (EVL). METHODS: Single-center randomized controlled trial (July 2022-June 2025). Cirrhotic patients with GOV were assigned 1:1 to EUS-CYA + bc-EIS (n = 62) or EUS-CYA + EVL (n = 62). All received EUS-guided "sandwich technique" for gastric varices (GV). Then, bc-EIS (polidocanol under balloon compression for 10 min) or EVL (spiral ligation) was performed for EV. The primary endpoint was combined eradication rate of both GV and EV at 6 months. RESULTS: GV final eradication: 100% in both groups. EV eradication: 100% in the bc-EIS group versus 82.3% in the EVL group (p < 0.001). Fewer sessions needed for bc-EIS (1.4 ± 0.6 vs. 2.1 ± 1.1, p < 0.001). Rebleeding: 9.7% versus 21.0% (p = 0.081). Independent rebleeding risk factors: esophageal variceal diameter > 10 mm (HR = 6.98) and prior bleeding (HR = 4.57). No significant differences in hemostasis (100% both), complications (14.5% vs. 17.7%), or recurrence (0 vs. 3.2%). No severe adverse events. CONCLUSION: EUS-CYA combined with bc-EIS significantly improves esophageal variceal eradication and reduces treatment sessions compared with EUS-CYA + EVL, with comparable safety. TRIAL REGISTRATION: ChiCTR2000039974.

Journal of Gastroenterology and Hepatology
Anhui Medical University (CN), First Affiliated Hospital of Anhui Medical University (CN)
National Natural Science Foundation of China
Openalex Percentile: Top 13%
Liver Disease and Transplantation
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