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Table 1 Study characteristics

From: Risk of rebleeding from gastroesophageal varices after initial treatment with cyanoacrylate; a systematic review and pooled analysis

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