Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)

Abstract Endoscopic injection sclerotherapy (EIS) is a useful prophylactic hemostatic procedure for esophageal varices. However, injecting sclerosing agents into blood vessels is technically challenging and often ineffective. Gel‐immersion EIS (GI‐EIS) may facilitate easier intravascular sclerosing...

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Main Authors: Noriaki Sugawara, Taro Iwatsubo, Yosuke Mori, Kazuki Takayama, Shun Sasaki, Noriyuki Nakajima, Hironori Tanaka, Akitoshi Hakoda, Satoshi Harada, Kazuhiro Ota, Toshihisa Takeuchi, Hiroki Nishikawa
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Language:English
Published: Wiley 2025-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.70056
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author Noriaki Sugawara
Taro Iwatsubo
Yosuke Mori
Kazuki Takayama
Shun Sasaki
Noriyuki Nakajima
Hironori Tanaka
Akitoshi Hakoda
Satoshi Harada
Kazuhiro Ota
Toshihisa Takeuchi
Hiroki Nishikawa
author_facet Noriaki Sugawara
Taro Iwatsubo
Yosuke Mori
Kazuki Takayama
Shun Sasaki
Noriyuki Nakajima
Hironori Tanaka
Akitoshi Hakoda
Satoshi Harada
Kazuhiro Ota
Toshihisa Takeuchi
Hiroki Nishikawa
author_sort Noriaki Sugawara
collection DOAJ
description Abstract Endoscopic injection sclerotherapy (EIS) is a useful prophylactic hemostatic procedure for esophageal varices. However, injecting sclerosing agents into blood vessels is technically challenging and often ineffective. Gel‐immersion EIS (GI‐EIS) may facilitate easier intravascular sclerosing agent injection by dilating the varices and enhancing scope stability by maintaining low intra‐gastrointestinal pressure. Therefore, we aimed to evaluate the effectiveness and safety of this procedure. This retrospective study included 18 patients (14 men and four women; median age, 70 years; age range, 18–83 years) who underwent GI‐EIS at Osaka Medical Pharmaceutical University Hospital between December 1, 2022, and January 30, 2024. Patients who were at least 18 years of age at the time of treatment were included. No patients were excluded from the study. Thirty‐four punctures were performed. The donor vessel angiography success rate was 88.2% (30 of 34 punctures). The clinical success rate was 94.4% (17 of 18 patients). Esophageal varices in most patients disappeared or were reduced by 1 month after treatment. Adverse events related to the procedure included fever (three patients) and chest pain (one patient); however, both were resolved with conservative treatment. No respiratory deterioration due to aspiration occurred during the procedure. The results of this study demonstrate that GI‐EIS is a safe, clinically feasible, and effective treatment option for prophylactic hemostasis of esophageal varices.
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spelling doaj-art-e6829df0f3cb49ac8a13554bb4d5abc42025-08-20T03:13:51ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70056Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)Noriaki Sugawara0Taro Iwatsubo1Yosuke Mori2Kazuki Takayama3Shun Sasaki4Noriyuki Nakajima5Hironori Tanaka6Akitoshi Hakoda7Satoshi Harada8Kazuhiro Ota9Toshihisa Takeuchi10Hiroki Nishikawa11Second Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanSecond Department of Internal Medicine Osaka Medical and Pharmaceutical University Osaka JapanAbstract Endoscopic injection sclerotherapy (EIS) is a useful prophylactic hemostatic procedure for esophageal varices. However, injecting sclerosing agents into blood vessels is technically challenging and often ineffective. Gel‐immersion EIS (GI‐EIS) may facilitate easier intravascular sclerosing agent injection by dilating the varices and enhancing scope stability by maintaining low intra‐gastrointestinal pressure. Therefore, we aimed to evaluate the effectiveness and safety of this procedure. This retrospective study included 18 patients (14 men and four women; median age, 70 years; age range, 18–83 years) who underwent GI‐EIS at Osaka Medical Pharmaceutical University Hospital between December 1, 2022, and January 30, 2024. Patients who were at least 18 years of age at the time of treatment were included. No patients were excluded from the study. Thirty‐four punctures were performed. The donor vessel angiography success rate was 88.2% (30 of 34 punctures). The clinical success rate was 94.4% (17 of 18 patients). Esophageal varices in most patients disappeared or were reduced by 1 month after treatment. Adverse events related to the procedure included fever (three patients) and chest pain (one patient); however, both were resolved with conservative treatment. No respiratory deterioration due to aspiration occurred during the procedure. The results of this study demonstrate that GI‐EIS is a safe, clinically feasible, and effective treatment option for prophylactic hemostasis of esophageal varices.https://doi.org/10.1002/deo2.70056digestive system endoscopyendoscopic injection sclerotherapyesophageal varicesgel immersion endoscopyprophylactic hemostasis
spellingShingle Noriaki Sugawara
Taro Iwatsubo
Yosuke Mori
Kazuki Takayama
Shun Sasaki
Noriyuki Nakajima
Hironori Tanaka
Akitoshi Hakoda
Satoshi Harada
Kazuhiro Ota
Toshihisa Takeuchi
Hiroki Nishikawa
Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
DEN Open
digestive system endoscopy
endoscopic injection sclerotherapy
esophageal varices
gel immersion endoscopy
prophylactic hemostasis
title Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
title_full Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
title_fullStr Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
title_full_unstemmed Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
title_short Novel gel‐immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices: A pilot feasibility and safety study (with video)
title_sort novel gel immersion endoscopic injection sclerotherapy method for prophylactic hemostasis of esophageal varices a pilot feasibility and safety study with video
topic digestive system endoscopy
endoscopic injection sclerotherapy
esophageal varices
gel immersion endoscopy
prophylactic hemostasis
url https://doi.org/10.1002/deo2.70056
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