EUS-Guided Coil and Glue for Gastric Varices

This trial tests a new method to treat stomach bleeding caused by liver disease. Currently, doctors use glue to stop the bleeding, but this trial adds small coils to the glue to see if it improves effectiveness. The goal is to reduce the risk of recurrent bleeding and enhance treatment safety. People with liver disease and specific types of stomach bleeding might be suitable candidates for this trial. Participants will receive either the new EUS-guided coil and cyanoacrylate glue injection treatment or the standard endoscopic cyanoacrylate glue injection treatment. As an unphased trial, this study provides a unique opportunity to explore innovative treatment options that could improve patient outcomes.

Research has shown that EUS-guided coil and glue injection is generally safe for treating bleeding in the stomach caused by swollen veins, known as gastric varices. One study found that patients undergoing this procedure experienced fewer side effects compared to those receiving the traditional glue injection. The study also revealed that the EUS-guided method was not only safer but required fewer sessions to achieve full effectiveness. Another study confirmed the safety and feasibility of this approach, even for patients with severe liver disease.

The traditional method, endoscopic glue injection, is already a common treatment for gastric varices. Although complications can occur, it is usually well-tolerated.

Researchers are excited about these treatments for gastric varices because they offer innovative approaches to managing bleeding. The EUS-guided Coil and Glue Injection combines endoscopic ultrasound with embolization coils followed by cyanoacrylate glue to precisely target and seal bleeding varices, potentially providing more effective and targeted treatment compared to conventional methods. This technique allows for real-time monitoring and follow-up through ultrasound, ensuring complete obliteration of varices. In contrast, the standard Endoscopic Glue Injection applies glue directly onto the varices, which can be effective but lacks the additional precision and monitoring capability of the EUS-guided method. These advancements could lead to improved outcomes and reduced recurrence of bleeding, making them a promising step forward in treatment options.

Research has shown that EUS-guided coil and glue injection, a treatment in this trial, effectively treats gastric varices, which are swollen veins in the stomach. Studies indicate that this method successfully closes these veins about 90.9% of the time. It typically requires fewer repeat procedures compared to using glue alone, the treatment in another arm of this trial. Additionally, the EUS-guided coil and glue treatment is associated with a lower risk of the veins bleeding again. Overall, these findings suggest that combining coils and glue may lead to better outcomes for patients with bleeding gastric varices.²⁶⁷⁸⁹