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Background <p>Glue extrusion bleeding is a major complication of endoscopic cyanoacrylate glue injection for the treatment of gastric varices.&#xa0;However, its risk factors remain unclear.</p> Aims <p>This retrospective study aimed to evaluate the risk factors for bleeding associated with glue extrusion.</p> Methods <p>This study analyzed the medical data of cirrhotic patients who underwent endoscopic obliteration for gastric varices using cyanoacrylate glue between January 2016 and December 2022. The data within 1&#xa0;year after therapy were carried out with logistic regression. A nomogram model was constructed based on the factors.</p> Results <p>269 patients were enrolled. Risk factors associated with glue extrusion bleeding included the volume of the glue (≥ 4&#xa0;mL)(OR 1.289, 95% CI 1.051–1.580; <i>P</i> = 0.015), massive ascites (OR 5.645, 95% CI 2.260–14.097; <i>P</i> = 0.000), active hemorrhage during endoscopy (OR 2.830, 95% CI 1.284–6.234; <i>P</i> = 0.010), and the use of β-blockers was a protective factor (OR 0.185, 95% CI 0.07–0.485; <i>P</i> = 0.001). The nomogram model had good prediction accuracy, with an area under the curve of 0.74 (95% CI 0.658–0.822; <i>P</i> &lt; 0.001).</p> Conclusion <p>Massive ascites, active hemorrhage during endoscopy, glue volume ≥ 4&#xa0;mL, and the use of β-blockers are associated with glue extrusion bleeding. At-risk patients may benefit from controlling the volume of the glue, undergoing endoscopic ultrasound and using β-blockers.</p>

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Risk Factors for Glue Extrusion Bleeding After Endoscopic Injection of Cyanoacrylate Glue for Gastric Varices: A Retrospective Study of 269 Patients

  • 期刊论文

  • 发表日期：

    2025年3月31日

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  • Yihuan Hu,
  • Mei Zhou,
  • Deliang Liu,
  • Jian Gong

摘要

Background

Glue extrusion bleeding is a major complication of endoscopic cyanoacrylate glue injection for the treatment of gastric varices. However, its risk factors remain unclear.

Aims

This retrospective study aimed to evaluate the risk factors for bleeding associated with glue extrusion.

Methods

This study analyzed the medical data of cirrhotic patients who underwent endoscopic obliteration for gastric varices using cyanoacrylate glue between January 2016 and December 2022. The data within 1 year after therapy were carried out with logistic regression. A nomogram model was constructed based on the factors.

Results

269 patients were enrolled. Risk factors associated with glue extrusion bleeding included the volume of the glue (≥ 4 mL)(OR 1.289, 95% CI 1.051–1.580; P = 0.015), massive ascites (OR 5.645, 95% CI 2.260–14.097; P = 0.000), active hemorrhage during endoscopy (OR 2.830, 95% CI 1.284–6.234; P = 0.010), and the use of β-blockers was a protective factor (OR 0.185, 95% CI 0.07–0.485; P = 0.001). The nomogram model had good prediction accuracy, with an area under the curve of 0.74 (95% CI 0.658–0.822; P < 0.001).

Conclusion

Massive ascites, active hemorrhage during endoscopy, glue volume ≥ 4 mL, and the use of β-blockers are associated with glue extrusion bleeding. At-risk patients may benefit from controlling the volume of the glue, undergoing endoscopic ultrasound and using β-blockers.