Table 1 Study characteristics
Author (Year) | Country of study | Study design | Comparison groups | Lesion; precise location | Diagnoses | Liver function/ extent of cirrhosis before treatment - number of patients | Sample size; number of participants rebled (%) | Treatment urgency | Follow-up duration |
|---|---|---|---|---|---|---|---|---|---|
Ramond (1989) [17] | France | Case series | Butyl cyanoacrylate versus Sclerosant | Gastric; Unspecified | Cirrhosis; Portal vein thrombosis | Child-Pugh: A-12; B-11; C-4 | 27; 10 (37%) | Emergency and elective | 1–38 Months (Mean: 14.7 ± 11.0) |
Oho 1995 [18] | Japan | Randomized trial | Ethanolamine oleate or butyl cyanoacrylate | Gastric; cardiac and fundal. | Gastric varices | Child-Pugh: A-0; B-17; C-12 | 29; 9 (31%) | Emergency | 14 months |
D’Imperio 1996 [19] | Italy | Prospective | N-butyl-2- cyanoacrylate | Esophageal; Gastric; fundal Duodenal; | Upper gastrointestinal tract varices | Child-Pugh: A-17; B-37; C-23 | 24; 2 (3.7%) from gastric varices; 54; 0 (0%) from duodenal varices; Esophageal not reported | Emergency and elective | 6 Months |
Omar 1998 [20] | Egypt | Prospective trial | Polidocanol, ethanolamine, cyanoacrylate | Esophageal; | Schistosoma hepatic fibrosis | Data not accessed | 60; not reported | Emergency | Not accessed |
Kind 2000 [21] | Italy | Retrospective | One arm study: Bucrylate | Gastric; cardia and fundus | Gastric varices | Child-Pugh: A-8; B-64; C-101 | 174; 27 (15.52%) | Emergency | 12 years |
Evrad 2003 [22] | Belgium | Retrospective | N-butyl-2- cyanoacrylate versus Propranolol | Esophageal; unspecified Gastric; | Esophagogastric varices | Unspecified | 16; 4 (25%); Esophageal 5; 2 (40%) Gastric | Emergency | 6 weeks |
Noophun 2005 [23] | Thailand | Prospective | One arm study: cyanoacrylate | Gastric; fundus | Gastric varices | Child-Pugh: A-6; B-11; C-7 | 24; 10 (41.67%) | Emergency and elective | Minimum of 4 weeks |
Tan 2006 [24] | Taiwan | Prospective | Band ligation Versus N-butyl-2- cyanoacrylate | Gastric; fundus, antrum and isolated | Liver cirrhosis | Child-Pugh: A-13; B-26; C-10 | 49; 11 (22.45%) from cyanoacrylate group | Emergency | 680.67 ± 710.54 days |
Cheng 2007 [25] | China | Retrospective | One arm study: N-butyl-2- cyanoacrylate | Gastric; cardia and fundus | Gastric varices | Child-Pugh: A-194; B-254; C-134 | 635; 44 (8%) | Emergency | Up to 10 years |
Kuo 2007 [26] | China | Randomized trial | Histoacryl versus Histoacryl + hypertonic glucose solution | Gastric; | Gastric varices | Child-Pugh: A-20; B-36; C-11 | 67; 2 (5.9%) from histoacryl-alone group | Emergent and elective | 37.9 ± 18.5 months |
Hong 2009 [27] | Korea | Randomized trial | Endoscopic N-butyl-2-cyanoacrylate injection versus balloon-occluded retrograde transvenous obliteration | Gastric; unspecified | Gastric variceal hemorrhage | Child-Pugh: A-3; B-8; C-3 | 27; 10 (71.43%) from the N-butyl-2-cyanoacrylate group | Emergent and elective | Up to 17 Months |
Hou 2009 [28] | Taiwan | Randomized trial | 0.5 mL Versus 1.0 mL of cyanoacrylate | Gastric; cardiac, fundal and undetermined | Gastric variceal hemorrhage | Mean ± standard deviation of Child-Pugh scores: 0.5 mL group 7.61 ± 1.82 1.0 mL group 7.79 ± 2.27 | 46; 14 (29.79%) from the 0.5mls group; 44; 17 (38.64%) from the 1 ml group | Emergent and elective | Up to 2 years |
Procaccini 2009 [29] | USA | Retrospective | Cyanoacrylate versus TIPS | Gastric; unspecified | Gastric variceal hemorrhage | Model for End-Stage Liver Disease (MELD), Mean ± standard deviation score: Cyanoacrylate, 15.4 ± 6.3; TIPS, 15.7 ± 8.3 | 105; 13 (21.31%) from the Cyanoacrylate group | Emergent and elective | Up to 1 year |
Rivet 2009 [30] | France | Prospective | Cyanoacrylate versus Band ligation | Esophageal; | Portal hypertension due to portal vein thrombosis, biliary atresia and antitrypsin deficiency | Pediatric End-stage Liver Disease (PELD) model, mean ± 20.1 ± 9.9 | 8; 3 (37.5%) from cyanoacrylate group | Emergent and elective | 10.6 weeks |
Cheng 2010 [31] | China | Retrospective | Butyl cyanoacrylate | Gastric; cardiac and fundus | Gastric varices due to viral hepatitis and others | Child-Pugh: A-244; B-297; C-179; unspecified-33 | 753; 33 (4.38%) | Emergent and elective | Up to 6 months after initial endoscopy |
Choudhuri 2010 [32] | India | Prospective | N-butyl-2-cyanoacrylate | Gastric; unspecified | Gastric variceal hemorrhage | Child-Pugh: A-40; B-62; C-40 | 170; 23 (14.56%) | Emergent and elective | 30.7 + 17.2 months |
Mishra 2010 [33] | India | Prospective | Cyanoacrylate versus beta blocker | Gastric; cardiac, fundus and isolated Esophageal; | Gastric varices | Child-Pugh: A-4; B-12; C-17 | 33; 3 (9.09%) from the cyanoacrylate group | Emergency | 26 Months |
Soga 2010 [34] | Japan | Case report | N-butyl-2-cyanoacrylate | Gastric; Duodenal; | Gastroduodenal varices | Unspecified | 1; 0 (0%) | Elective | 53 days |
Binmoellar 2011 [35] | USA | Retrospective | N-butyl-2-cyanoacrylate | Gastric; fundus | Gastric varices; Non variceal lesion | MELD score < 10 mean ± standard deviation, 11 ± 40.7; MELD score 11–18 mean ± standard deviation, 12 ± 44.4; MELD score 19–24, mean ± standard deviation, 3 ± 11.1 | 24; 0 (0%) from gastric variceal group | Emergent and elective | 193 (24–589) days |
Kang 2011 [36] | Korea | Retrospective | N-butyl-2-cyanoacrylate cyanoacrylate | Gastric; cardiac, fundal and isolated | Gastric varices | Child-Pugh: A-42; B-59; C-26 | 127; 29 (22.83%) | Emergent and elective | 1 year |
Liao 2013 [37] | Taiwan | Prospective | Cyanoacrylate | Gastric; unspecified | Gastric varices | Child-Pugh: A-16; B-13; C-6 | 69; 10 (14.49%) | Emergency and elective | More than 30 months |
Tantau 2013 [38] | Romania | Prospective | Cyanoacrylate versus Band ligation | Gastric; cardiac and fundus | Gastric varices | Child-Pugh: A-11; B-18; C-8 | 37; 6 (31.58%) from the Cyanoacrylate group | Emergency and elective | 27.26 ± 214.16 days |
Al-Bawardy 2016 [39] | USA | Retrospective | 2-octyl cyanoacrylate | Gastric; fundal | Gastric Variceal Hemorrhage | MELD score median value, 11 | 95; 8 (8.42%) | Emergency | Up to 15 years |
Singh 2016 [10] | India | Prospective | Diluted versus undiluted cyanoacrylate | Gastric; cardiac, fundus and isolated | Gastric Variceal Hemorrhage | Child-Pugh: A-9; B-15; C-6 | 30; 5 (16.67%) | Emergency and elective | Up to one year |
Liu 2019 [40] | China | Prospective | Cyanoacrylate with versus without antibiotic | Gastric; unspecified | Gastric varices | Child-Pugh: A-76; B-31; C-0 | 107; 106 (99.07%) | Emergency | 4.59 ± 1.63; 4.30 ± 1.48 Days |
Xiaoqing 2019 [2] | China | Prospective | Cyanoacrylate versus cyanoacrylate + lauromacrogol | Gastric; cardiac, fundus and isolated | Gastric varices | Child-Pugh: A-27; B-74; C-9 | 130; 8 (12.90%) from the Cyanoacrylate group | Emergency | 38.8 months for Cyanoacrylate group |
Thakeb 1995 [41] | Egypt | Randomized trial | N-butyl-2-cyanoacrylate plus ethanolamine oleate 5% versus ethanolamine alone | Gastric; Unspecified Esophageal; | Gastroesophageal varices | Child-Pugh: A-16; B-33; C-9 | 57; 3 (5.26%) from the gastric varices; 59; 1 (1.69%) from the esophageal varices group. | Emergency and elective | Up to 32 months |
Maruyama 2010 [42] | Japan | Retrospective | Cyanoacrylate plus ethanolamine | Gastric; fundus | Gastric varices | Child-Pugh: A-2; B-4; C-4 | 20; 10 (50%) | Emergency | 28.1 months |
Bhat 2016 [43] | United States of America | Retrospective | Cyanoacrylate and coils guided by endoscopic ultrasound | Gastric; fundal | Gastric varices | MELD score < 10, 31; MELD score 11–18, 70; MELD score 19–24, 10; MELD score > 24, 3 | 125; 10 (8%) | Elective | Median: 436 days; |
Robles-Medranda 2019 [44] | Ecuador | Prospective | Cyanoacrylate and coils guided by endoscopic ultrasound | Gastric; cardiac, fundus and isolated | Gastric varices | Child-Pugh: A-28; B-2; C-17 | 30: 1 (3.7%) | Emergency and elective | Up to 12 months |
Zhang 2007 [16] | China | Randomized trial | Cyanoacrylate with percutaneous transhepatic variceal embolization | Esophageal; | Esophageal varices | Data not accessed | 92; 14 (16%) | Emergency and elective | Mean: 31.5 months |
Zhang 2008 [45] | China | Randomized trial | Cyanoacrylate with percutaneous transhepatic variceal embolization | Esophageal; cardiac, fundus and isolated | Esophageal varices | Child-Pugh: A-10; B-25; C-17 | 52; 8 (15.38%) | Emergency and elective | Median: 25 months |
Tian 2011 [46] | China | Prospective | Cyanoacrylate with percutaneous transhepatic variceal embolization | Gastric; cardiac, fundus, isolated | Gastric varices | Child-Pugh: A-24; B-31; C-17 | 71; 7 (9.86%) | Emergency and elective | Mean; 24.2 ± 12.4 months |
Feritis 1995 [47] | Greece | Randomized trial | Cyanoacrylate with sclerotherapy | Esophageal; | Esophageal varices | Child-Pugh: A-12; B-83; C-35 | 126; 8 (11.94%) | Emergency | 30 days |
Dhiman 2002 [48] | India | Prospective | Cyanoacrylate with sclerotherapy | Gastric; fundal | Gastric varices | Child-Pugh: A-5; B-5; C-3 | 29; 3 (10.34%) | Emergency and elective | Up to 6 months |
Shi 2014 [49] | China | Retrospective | Transjugular intrahepatic portosystemic shunt alone versus combined with cyanoacrylate | Esophageal; | Esophageal Variceal Bleeding | Child-Pugh: A-27; B-57; C-17 | 53; 3 (5.66%) | Emergency | 35.8 months |
Ma 2018 [50] | China | Prospective | Combined cyanoacrylate with balloon-occluded retrograde transvenous obliteration | Gastroesophageal; | Gastroesophageal varices | Child-Pugh: A-16; B-10; C-2 | 28; 8 (31%) | Elective | 90 days |
Dai 2017 [51] | China | Randomized trial | Band ligation alone versus in combination with cyanoacrylate | Gastroesophageal; | Gastroesophageal varices | Data not accessed | 97; 7 (14.29%) | Emergency and elective | 20 months |
Zeng 2017 [52] | China | Randomized trial | Cyanoacrylate plus polidocanol versus cyanoacrylate plus lipiodol in | Gastric; cardiac, fundus and isolated | Gastric varices | Child-Pugh: A-50; B-44; C-4 | 96; 11 (11.70%) | Emergency and elective | 6 months |