Aims: To evaluate the utility of endoscopic obliterative therapy with n-butyl-2-cyanoacrylate (a tissue adhesive) for gastric varices and to assess the incidence of serious complications.  

Methods: Endoscopic obliterative therapy with n-butyl-2 cyanoacrylate was performed on two groups of patients with gastric varices. One group consisted of 129 patients from year 1992 through 2000, and the second of 92 from 2001 through 2014 (total=221).  Endoscopic therapy was performed under fluoroscopy using 70% cyanoacrylate diluted with 5% Lipiodol.  

Results: Endoscopic obliterative therapy with cyanoacrylate for gastric varices was successful in all 221 cases. The recurrence rate was 30/210 (14.3%) among patients wherre variceal eradication had been achieved. Additional treatment was successfully performed in all recurrent cases. The incidence of serious complications in the first group was 4/129 (3.1%), including two cases of splenic infarction, one of pulmonary embolism, and one of an inflammatory tumour of the pancreatic tail. In contrast, there were no serious complications was in the group treated later using smaller amounts of n-butyl-2cyanoacrylate.  

Conclusions: Endoscopic obliterative therapy with cyanoacrylate is a useful and relatively safe method for treatment of bleeding gastric varices.  Nonetheless, careful attention must be paid to the avoidance of potentially serious complications.  

Keywords: N-butyl-2-cyanoacrylate; Endoscopic Obliterative Therapy; Gastric Varices; Histoacryl®