To investigate the safety, efficacy and operation cautions of clip-assisted endoscopic cyanoacrylate injection for patients with gastric varices.

A retrospective study was performed on the data of 10 patients with gastric varices undergoing clip-assisted endoscopic cyanoacrylate injection in Department of Gastroenterology of Eastern District of Shandong Provincial Hospital Affiliated to Shandong University from January 2018 to July 2019.GOV2/IGV1 was confirmed by endoscopy examination and a gastro-renal shunt was confirmed by contrast-enhanced CT and CT angiography(CTA)for all patients.The inflow or outflow veins of the gastric varices were observed and clamped with metal clips to slow down or completely block the gastric variceal blood flow, followed by cyanoacrylate injection into the gastric varices, which could reduce the risk of ectopic embolization.The technical successful rate, the eradication of gastric varices, the rebleeding rate and complications were analyzed.

All patients successfully completed the procedure.The mean follow-up was 85.7 days(range 39-157 days). Gastric varices were eradicated in all patients according to contrast-enhanced CT reexamination.Rebleeding occurred in one patient because of post-injection ulcer.No symptoms related to ectopic embolization occurred.No serious complications occurred.

Clip-assisted endoscopic cyanoacrylate injection is safe and reliable for gastric varices patients with gastro-renal shunt, which deserves further clinical research.

Gastric varices; Endoscopic therapy; Clip-assisted endoscopic cyanoacrylate injection; Gastro-renal shunt; Ectopic embolization