**EMBARGOED All research presented at the ACG Annual Scientific Meeting is strictly embargoed until Monday, October 19, 2015 at 8 AM (EDT).
Poster 1585 Clinical Outcomes of Endoscopic Cyanoacrylate Injection Sclerotherapy With Post- Injection Audible Doppler Ultrasonography
Author Insight from Tom D. Catron, MD, Virginia Commonwealth University Medical Center, Department of Gastroenterology
What’s new here and important for clinicians?
The use of a through-scope audible Doppler for assessment of obliteration of gastric varices may reduce the rate of rebleeding in patients treated with cyanoacrylate injection for acute gastric variceal hemorrhage. Most institutions that treat gastric varices with cyanoacrylate compounds use blunt endoscope probing to confirm variceal obliteration. The incorporation of audible doppler may be more effective than blunt probing, as it is an instrument that has been used in prior studies to detect arterial and venous flow. The comparison of rebleeding rates after cyanoacrylate treatment with audible doppler assessment to prior cyanoacrylate studies with blunt probing suggests that rebleeding rates may be lowered when variceal obliteration is confirmed with doppler. The findings in this study warrant continued investigation of the utilization of audible doppler in cyanoacrylate injection to make this therapy for gastric variceal hemorrhage as safe and effective as possible.
What do patients need to know?
Variceal bleeding in the stomach can be a life-threatening event that requires fast treatment. “Glue injection” therapy (cyanoacrylate injection) for gastric variceal bleeding has been shown to be a safe and effective method to stop variceal bleeding. Physicians usually press the tip of their endoscopic instrument to assess adequate treatment of the vessel in a technique called “blunt probing.” There may be some benefit in the use of a Doppler ultrasound that produces audible signals of blood flow to confirm that blood flow of these treated vessels have truly stopped. This audible Doppler can be pushed through the endoscope directly after injection to make this assessment. Comparisons between the use of an audible doppler ultrasound with prior studies of variceal gluing in which blunt probing was used suggest that using audible Doppler after injection may reduce rates of rebleeding after a variceal bleed.
Author Contact Tom D. Catron, M.D., Virginia Commonwealth University Medical Center, Department of Gastroenterology
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