Abstract：
UNASSIGNED: Gastric varices (GV) with spontaneous portosystemic shunt (SPSS) are associated with ectopic embolism in endoscopic cyanoacrylate. This study targeted to assess the efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration (BRTO) for GV with high-risk ectopic embolism.
UNASSIGNED: We retrospectively analyzed six tertiary hospitals\' 104 patients with GV at high-risk ectopic embolism (the narrowest diameter of SPSS was greater than or equal to 5 mm and the maximum diameter usually >8 mm) who underwent EUS-guided coil embolization combined with endoscopic cyanoacrylate injection or BRTO from January 2014 to December 2020. The outcomes included rebleeding, survival, and complications.
UNASSIGNED: The EUS group and BRTO group contained 59 and 45 patients, respectively. The technical success rate between the two groups was similar (96.6% vs. 95.6%, P = 1.000). During the follow-up, both groups\' 5-day rebleeding rate and 6-week mortality rate were 0%. One-year all-cause rebleeding rate (20.0% vs. 18.9%, P = 0.900) and 1-year mortality rate (2.0% vs. 0%, P = 1.000) in the EUS group were similar to the BRTO group. One patient experienced ectopic embolism in the EUS group, while the BRTO group did not. Both groups had similar mean days (16.0 [interquartile range (IQR), 12.0-19.0] vs. 16.5 [IQR, 11.8-26.0], P = 0.165) and cost of hospitalization (¥ 45950.6 [IQR, 39330.2-55768.2] vs. ¥ 51205.8 [IQR, 31628.8-74251.5], P = 0.680). Multivariate analysis showed that the narrowest diameter of the shunt (odds ratio [OR] = 1.86; 95% confidence interval [CI]: 1.062-3.258; P = 0.03) and content of hemoglobin (OR = 0.941; 95% CI: 0.892-0.992; P = 0.025) were the prognostic factors for survival.
UNASSIGNED: The efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection for GV with high-risk ectopic embolism are comparable to BRTO.
UNASSIGNED: We retrospectively analyzed six tertiary hospitals\' 104 patients with GV at high-risk ectopic embolism (the narrowest diameter of SPSS was greater than or equal to 5 mm and the maximum diameter usually >8 mm) who underwent EUS-guided coil embolization combined with endoscopic cyanoacrylate injection or BRTO from January 2014 to December 2020. The outcomes included rebleeding, survival, and complications.
UNASSIGNED: The EUS group and BRTO group contained 59 and 45 patients, respectively. The technical success rate between the two groups was similar (96.6% vs. 95.6%, P = 1.000). During the follow-up, both groups\' 5-day rebleeding rate and 6-week mortality rate were 0%. One-year all-cause rebleeding rate (20.0% vs. 18.9%, P = 0.900) and 1-year mortality rate (2.0% vs. 0%, P = 1.000) in the EUS group were similar to the BRTO group. One patient experienced ectopic embolism in the EUS group, while the BRTO group did not. Both groups had similar mean days (16.0 [interquartile range (IQR), 12.0-19.0] vs. 16.5 [IQR, 11.8-26.0], P = 0.165) and cost of hospitalization (¥ 45950.6 [IQR, 39330.2-55768.2] vs. ¥ 51205.8 [IQR, 31628.8-74251.5], P = 0.680). Multivariate analysis showed that the narrowest diameter of the shunt (odds ratio [OR] = 1.86; 95% confidence interval [CI]: 1.062-3.258; P = 0.03) and content of hemoglobin (OR = 0.941; 95% CI: 0.892-0.992; P = 0.025) were the prognostic factors for survival.
UNASSIGNED: The efficacy and safety of EUS-guided coil embolization combined with endoscopic cyanoacrylate injection for GV with high-risk ectopic embolism are comparable to BRTO.
摘要：
UNASSIGNED：自发性门体分流术（SPSS）的胃静脉曲张（GV）与内窥镜氰基丙烯酸酯的异位栓塞有关。本研究旨在评估EUS引导的弹簧圈栓塞联合内窥镜氰基丙烯酸酯注射与球囊闭塞逆行静脉闭塞（BRTO）治疗GV高危异位栓塞的疗效和安全性。
UNASSIGNED：我们回顾性分析了6家三级医院的104例GV高危异位栓塞患者（SPSS最窄直径大于或等于5mm，最大直径通常>8mm），他们在2014年1月至2020年12月期间接受了EUS引导下的线圈栓塞联合内窥镜氰基丙烯酸酯注射或BRTO。结果包括再出血，生存,和并发症。
未经评估：EUS组和BRTO组包含59和45名患者，分别。两组的技术成功率相似(96.6%vs.95.6%,P=1.000)。在后续行动中,两组5天再出血率和6周死亡率均为0%.一年全因再出血率（20.0%vs.18.9%,P=0.900）和1年死亡率（2.0%vs.0%,EUS组的P=1.000）与BRTO组相似。EUS组一名患者出现异位栓塞,而BRTO组没有。两组的平均天数相似(16.0[四分位数间距(IQR)，12.0–19.0]vs.16.5[IQR，11.8-26.0],P=0.165)和住院费用(¥45950.6[IQR，39330.2-55768.2]vs.¥51205.8[IQR,31628.8-74251.5],P=0.680）。多因素分析显示，分流管最窄直径（比值比[OR]=1.86；95％置信区间[CI]：1.062-3.258；P=0.03）和血红蛋白含量（OR=0.941；95％CI：0.892-0.992；P=0.025）是影响生存的预后因素。
UNASSIGNED：EUS引导的弹簧圈栓塞联合内镜下氰基丙烯酸酯注射治疗GV高危异位栓塞的疗效和安全性与BRTO相当。
UNASSIGNED：我们回顾性分析了6家三级医院的104例GV高危异位栓塞患者（SPSS最窄直径大于或等于5mm，最大直径通常>8mm），他们在2014年1月至2020年12月期间接受了EUS引导下的线圈栓塞联合内窥镜氰基丙烯酸酯注射或BRTO。结果包括再出血，生存,和并发症。
未经评估：EUS组和BRTO组包含59和45名患者，分别。两组的技术成功率相似(96.6%vs.95.6%,P=1.000)。在后续行动中,两组5天再出血率和6周死亡率均为0%.一年全因再出血率（20.0%vs.18.9%,P=0.900）和1年死亡率（2.0%vs.0%,EUS组的P=1.000）与BRTO组相似。EUS组一名患者出现异位栓塞,而BRTO组没有。两组的平均天数相似(16.0[四分位数间距(IQR)，12.0–19.0]vs.16.5[IQR，11.8-26.0],P=0.165)和住院费用(¥45950.6[IQR，39330.2-55768.2]vs.¥51205.8[IQR,31628.8-74251.5],P=0.680）。多因素分析显示，分流管最窄直径（比值比[OR]=1.86；95％置信区间[CI]：1.062-3.258；P=0.03）和血红蛋白含量（OR=0.941；95％CI：0.892-0.992；P=0.025）是影响生存的预后因素。
UNASSIGNED：EUS引导的弹簧圈栓塞联合内镜下氰基丙烯酸酯注射治疗GV高危异位栓塞的疗效和安全性与BRTO相当。
