82250
document
Randomized , controlled study of various agents for endoscopic injection sclerotherapy of bleeding canine gastric varices . The purpose of this study was to compare the relative efficacy and technical ease of use of eight different agents for endoscopic hemostasis and obliteration of bleeding gastric varices in a canine model , as no comparative data are available on gastric variceal sclerotherapy . Large bleeding gastric varices in 20 heparinized dogs were randomized to endoscopic injection treatment with one of the following agents : cyanoacrylate ; a 1:1:1 mixture of sodium tetradecyl sulfate 3 % , ethanol 98 % , and normal saline solution ; ethanolamine oleate 5 % ; sodium morrhuate 5 % ; sodium tetradecyl sulfate 1.5 % ; polidocanol 1 % ; normal saline solution with epinephrine 1:10,000 ; or normal saline solution ( control ) . The number and volume of injections and the time required to achieve complete hemostasis were evaluated ; follow-up endoscopy was performed at 1 month to assess gastric variceal obliteration . Cyanoacrylate was the best agent overall in terms of immediate efficacy , low volume requirement , time required for initial hemostasis , and reduction of gastric variceal size . Cyanoacrylate , tetradecyl sulfate , and polidocanol were the most effective agents for reducing gastric variceal size . Epinephrine was effective for controlling induced or secondary bleeding caused by puncture of the gastric varices with the sclerotherapy needle during intravariceal injections . Ongoing studies are evaluating combinations of agents with different mechanisms of action , such as epinephrine ( for vasoconstriction to minimize secondary bleeding ) plus alcohol , and/or tetradecyl sulfate ( for variceal thrombosis and sclerosis ) . ( ABSTRACT TRUNCATED AT 250 WORDS )
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Intervention_Pharmacological
cyanoacrylate
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Intervention_Pharmacological
a 1:1:1 mixture of sodium tetradecyl sulfate 3 % , ethanol 98 % , and normal saline solution
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Intervention_Pharmacological
ethanolamine oleate 5 %
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Intervention_Pharmacological
sodium morrhuate 5 % ; sodium tetradecyl sulfate 1.5 % ; polidocanol 1 %
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Intervention_Pharmacological
normal saline solution with epinephrine 1:10,000
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Intervention_Control
normal saline solution ( control )
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Outcome_Other
relative efficacy and technical ease of use
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Outcome_Other
immediate efficacy
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Outcome_Physical
low volume requirement
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Outcome_Other
time required for initial hemostasis
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Outcome_Physical
reduction of gastric variceal size
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Outcome_Other
Cyanoacrylate
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Outcome_Other
tetradecyl sulfate
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Outcome_Other
polidocanol
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Outcome_Physical
induced or secondary bleeding
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Participant_Sample-size
20
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Participant_Condition
heparinized