{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T09:41:35Z","timestamp":1792748495836,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic ultrasound (EUS)\u2010guided injection of cyanoacrylate (CYA) for primary prophylaxis (PP) of gastric varices (GV) is controversial. This study evaluates the safety and efficacy of this intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients treated for PP of GV bleeding by EUS injection of CYA with or without coils were identified. Endoscopic techniques, outcomes, and adverse events (AEs) were reviewed and compared with a group treated for secondary prophylaxis (SP). Patients were followed until: (i) loss to follow\u2010up; (ii) GV bleeding; (iii) interventional radiology or surgery decompression; (iv) liver transplant; or (v) death or comfort care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and nineteen patients (61 men; mean 59\u2009\u00b1\u200912\u2009years) underwent EUS for PP (<jats:italic>n<\/jats:italic>\u2009=\u200924) or SP (<jats:italic>n<\/jats:italic>\u2009=\u200995). The PP group was treated with CYA alone (<jats:italic>n<\/jats:italic>\u2009=\u200918) or with coils (<jats:italic>n<\/jats:italic>\u2009=\u20094). Eight (33%) mild (<jats:italic>n<\/jats:italic>\u2009=\u20096) or moderate (<jats:italic>n<\/jats:italic>\u2009=\u20092) AEs and no\u00a0index GV bleeding occurred during a mean of 6.1\u2009\u00b1\u20095.9\u2009months follow\u2010up. Repeat EUS in 22 (92%) PP patients showed 7 (32%) residual GVs, which were retreated with CYA alone (<jats:italic>n<\/jats:italic>\u2009=\u20096) or with coils (<jats:italic>n<\/jats:italic>\u2009=\u20091). Two (29%) mild (<jats:italic>n<\/jats:italic>\u2009=\u20091) or moderate (<jats:italic>n<\/jats:italic>\u2009=\u20091) AEs occurred after repeat EUS and 1\/22 (5%) index GV bleed occurred during a mean 23\u2009\u00b1\u200925\u2009months follow\u2010up. Compared to the SP group, the PP group had lower Model for End\u2010stage Liver Disease (MELD) score\u00a0(<jats:italic>P<\/jats:italic>\u2009=\u20090.03), fewer GV stigmata (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), required less CYA (<jats:italic>P<\/jats:italic>\u2009=\u20090.019) during index EUS, and had a longer time between index and surveillance EUS (<jats:italic>P<\/jats:italic>\u2009=\u20090.014). The incidence of AEs and GV bleeding between the two groups were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Posttreatment GV bleeding and AEs are similar following EUS\u2010guided primary and secondary GV prophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14713","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T08:19:59Z","timestamp":1698394799000},"page":"710-718","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of endoscopic ultrasound\u2010guided primary and secondary prophylaxis for gastric variceal bleeding"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8548-8572","authenticated-orcid":false,"given":"Yara","family":"Sarkis","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Masuoka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Ghabril","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Gutta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Al\u2010Haddad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stainko","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lainna","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Indiana University Health Medical Center  Indianapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.01.027"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6462-z"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.01.025"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160607"},{"key":"e_1_2_7_6_1","unstructured":"AleemA ShahH.Gastric varices [Internet]. Treasure Island: Aleem Abdul; c2023 [revised 2023 Mar 27; cited 2023 May 30]. 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