Endoscopic injection sclerotherapy with 1.5% Sotradecol for bleeding cardiac varices

King Wah Chiu*, Chi Sin Changchien, Seng Kee Chuah, Dar In Tai, Shue Shian Chiou, Chuan Mo Lee, Jyh Jou Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

20 Scopus citations

Abstract

The authors retrospectively studied the efficacy of endoscopic injection sclerotherapy (EIS) with 1.5% Sotradecol (STD) in patients with bleeding cardiac varices (CV). Case histories of 27 patients with large, isolated, bleeding CVs were reviewed. Case records of another 27 patients with isolated esophageal varices (EV), matched for age, sex, and year EIS was performed, were selected from a computer data bank as controls. Using a small volume (2- 4 ml) of injection per vessel, the rate of immediate control of bleeding was 66.7% (18 of 27) in the CV group and 70.4% (19 of 27) in the EV group. The early rebleeding rate was higher for patients in the EV group (48.1%. 13 of 27) than for those in the CV group (18.5%, 5 of 27) (p = 0.0209). On the other hand, it was more difficult to control the rebleeding from CV (p = 0.00494). In terms of mortality, there was no statistically significant difference between the CV and EV groups (33.3 versus 29.6%) within 1 week after EIS, but the 1-month post EIS mortality rate was significantly higher (p = 0.0278) in the CV group (18 of 27, 66,7%) than in the EV group (10 of 27.37.0%). Among those in the CV group who died of late complications within 1 month after EIS, three died of recurrent hemorrhage, five of infection, and one of viscus perforation. In the EV group, only two patients died of infection. Thus, it was concluded that EIS with small volumes (2-4 ml) of 1.5% STD was equally effective in controlling immediate bleeding froth CV and EV. However, it was more difficult to control early rebleeding from CV, and the mortality and complications within 1 month after EIS were significantly higher in patients with CV. These observations are currently under careful study and evaluation.

Original languageEnglish
Pages (from-to)161-164
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume24
Issue number3
DOIs
StatePublished - 04 1997
Externally publishedYes

Keywords

  • Endoscopic injection sclerotherapy
  • Esophageal varices
  • Gastric varices
  • Sclerosant

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