{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T09:41:32Z","timestamp":1792748492580,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Objectives:<\/jats:title>\n            <jats:p>Gastric varices (GV) with spontaneous portosystemic shunt (SPSS) are associated with ectopic embolism in endoscopic cyanoacrylate. This study targeted to assess the efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection <jats:italic toggle=\"yes\">versus<\/jats:italic> balloon-occluded retrograde transvenous obliteration (BRTO) for GV with high-risk ectopic embolism.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods:<\/jats:title>\n            <jats:p>We retrospectively analyzed six tertiary hospitals\u2019 104 patients with GV at high-risk ectopic embolism (the narrowest diameter of SPSS was greater than or equal to 5 mm and the maximum diameter usually &gt;8 mm) who underwent EUS-guided coil embolization combined with endoscopic cyanoacrylate injection or BRTO from January 2014 to December 2020. The outcomes included rebleeding, survival, and complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The EUS group and BRTO group contained 59 and 45 patients, respectively. The technical success rate between the two groups was similar (96.6% <jats:italic toggle=\"yes\">vs<\/jats:italic>. 95.6%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 1.000). During the follow-up, both groups\u2019 5-day rebleeding rate and 6-week mortality rate were 0%. One-year all-cause rebleeding rate (20.0% <jats:italic toggle=\"yes\">vs<\/jats:italic>. 18.9%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.900) and 1-year mortality rate (2.0% <jats:italic toggle=\"yes\">vs<\/jats:italic>. 0%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 1.000) in the EUS group were similar to the BRTO group. One patient experienced ectopic embolism in the EUS group, while the BRTO group did not. Both groups had similar mean days (16.0 [interquartile range (IQR), 12.0\u201319.0] <jats:italic toggle=\"yes\">vs<\/jats:italic>. 16.5 [IQR, 11.8\u201326.0], <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.165) and cost of hospitalization (\u00a5 45950.6 [IQR, 39330.2\u201355768.2] <jats:italic toggle=\"yes\">vs<\/jats:italic>. \u00a5 51205.8 [IQR, 31628.8\u201374251.5], <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.680). Multivariate analysis showed that the narrowest diameter of the shunt (odds ratio [OR] = 1.86; 95% confidence interval [CI]: 1.062\u20133.258; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03) and content of hemoglobin (OR = 0.941; 95% CI: 0.892\u20130.992; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.025) were the prognostic factors for survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection for GV with high-risk ectopic embolism are comparable to BRTO.<\/jats:p>\n          <\/jats:sec>","DOI":"10.4103\/eus-d-21-00260","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T11:26:52Z","timestamp":1669807612000},"page":"74-83","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":24,"title":["Efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration for gastric varices with high-risk ectopic embolism: A multicenter and retrospective cohort study"],"prefix":"10.1097","volume":"12","author":[{"given":"Ziyin","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Digestive System, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujing","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Ma","sequence":"additional","affiliation":[{"name":"Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Wang","sequence":"additional","affiliation":[{"name":"Endoscopy Center, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honggang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingkai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"R1-20250826","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1053\/j.gastro.2018.01.028","article-title":"Association between portosystemic shunts and increased complications and mortality in patients with cirrhosis","volume":"154","author":"Sim\u00f3n-Talero","year":"2018","journal-title":"Gastroenterology"},{"key":"R2-20250826","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1002\/hep.23259","article-title":"Acute portal vein thrombosis unrelated to cirrhosis:A prospective multicenter follow-up study","volume":"51","author":"Plessier","year":"2010","journal-title":"Hepatology"},{"key":"R3-20250826","doi-asserted-by":"crossref","first-page":"143","DOI":"10.3748\/wjg.v16.i2.143","article-title":"Portal vein thrombosis:Insight into physiopathology, diagnosis, and 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