Endoscopic ultrasound-guided therapies versus retrograde transvenous obliteration for gastric varices: Multicenter propensity matched analysis

作者：Suprabhat Giri, Ranjan Kumar Patel, Radhika Chavan, Bhavik Shah, Jimmy Narayan, Taraprasad Tripathy, Sushant Babbar, Lalit Garg, Rozil Gandhi, Karan Manoj Anandpara, Swati Das, Manjit Kanungo, Girish Kumar Pati, Hemanta Kumar Nayak, Manas Kumar Panigrahi, Preetam Nath, Saroj Kanta Sahu, Dibya Lochan Praharaj, Bipadabhanjan Mallick, Sarat Chandra Panigrahi, Sanjay Rajput, Jimil Shah, Anil C. Anand, Manoj Kumar Sahu · 发表于：Endoscopy International Open · 年份：2025 · DOI：10.1055/a-2549-1165 · 被引用次数：5 · 研究领域：Liver Disease and Transplantation、Diagnosis and Treatment of Venous Diseases、Organ Transplantation Techniques and Outcomes

Abstract Retrograde transvenous obliteration (RTO) is an established technique for managing fundal varices. Endoscopic ultrasound (EUS)-guided glue injection with or without coil is an alternate approach. The present study compared outcomes of EUS-guided therapies with RTO for managing fundal varices. We retrospectively analyzed data from patients with fundal varices undergoing EUS-guided intervention or RTO at 10 tertiary centers in India and compared after propensity score matching. The primary outcome was variceal bleeding within 1 year. Secondary outcomes included procedure-related adverse events (AEs), variceal obliteration, reintervention, and mortality. A total of 167 patients (EUS 108, RTO 59) were included, with 59 in each group after propensity score matching. Incidence of variceal bleeding (15.3% vs. 13.6%, P = 0.793) within 1 year was comparable between the groups. Procedure-related AEs were higher in the RTO group (22% vs. 5.1%, P = 0.007), primarily new onset or worsening of ascites. Variceal obliteration at 4 weeks was similar between groups (83.1% vs. 91.5%, P = 0.167). Although reintervention within 1 year of the index procedure (30.5% vs. 22.0%, P = 0.296) was comparable, the EUS group required more frequent reintervention for GVs (28.8% vs. 5.1%, P = 0.001), and the RTO group required more frequent reintervention for EVs (16.9% vs. 1.7%, P = 0.008). EUS-guided therapy offers a safe and effective alternative to RTO for managing fundal varices. Although reint...