{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:19:04Z","timestamp":1792718344963,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270623"],"award-info":[{"award-number":["82270623"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Isolated gastric varices type 1 (IGV1) with spontaneous shunts carry a high risk of bleeding and ectopic embolization following cyanoacrylate injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to compare the efficacy and safety of endoscopic ultrasonography-guided cyanoacrylate injection (EUS-CYA) versus direct endoscopic injection of cyanoacrylate (DEI-CYA) in patients with IGV1 and spontaneous shunts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A prospective randomized controlled trial (RCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective RCT enrolled patients with cirrhosis complicated by IGV1 and spontaneous portosystemic shunts. Eligible patients were randomly assigned to either the EUS-CYA group or the DEI-CYA group. The primary outcome was the rebleeding rate, while the secondary outcomes included technical success rate, gastric varices occlusion rate, cumulative non-bleeding rate, mortality rate, and incidence of ectopic embolization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 96 patients were randomized to either the EUS-CYA (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200947) or DEI-CYA (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200949) group, both achieving 100% technical success. The rebleeding rate was significantly lower in the EUS-CYA group compared to the DEI-CYA group (19.15% vs 42.86%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012), particularly for late rebleeding (17.02% vs 36.73%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03). Kaplan\u2013Meier analysis showed that the cumulative non-bleeding rates at 6, 12, 18, and 24\u2009months were higher in the EUS-CYA group compared to the DEI-CYA group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.042). Mortality rates were similar between the groups (12.77% vs 16.33%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.621). No ectopic embolization occurred in the EUS-CYA group, while one case of pulmonary embolism was observed in the DEI-CYA group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EUS-CYA demonstrates a higher gastric varices occlusion rate and a lower rebleeding rate for IGV1 with spontaneous shunts compared to DEI-CYA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry, ChiCTR2200058888.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848251413353","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T01:40:41Z","timestamp":1768354841000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Endoscopic ultrasonography-guided cyanoacrylate injection versus endoscopic cyanoacrylate injection for treating isolated gastric varices type 1 bleeding with spontaneous shunts: a randomized controlled trial"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5950-1422","authenticated-orcid":false,"given":"Jing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Third People\u2019s Hospital of Bengbu, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxian","family":"Kuai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuecan","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3273-5760","authenticated-orcid":false,"given":"Derun","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui 230000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.01.027"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2014.08.010"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/1735-1995.172990"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.09.040"},{"key":"e_1_3_4_6_2","article-title":"Endoscopic treatment of variceal upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) cascade guideline","volume":"8","author":"Karstensen JG","year":"2020","unstructured":"Karstensen JG, Ebigbo A, Bhat P, et al. 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