Randomized trial compares aggressive and conservative cyanoacrylate approaches for managing variceal bleeding in patients, suggesting important treatment implications.
Gastric variceal bleeding remains one of the most severe complications of portal hypertension. While cyanoacrylate injection has become established as the cornerstone of endoscopic treatment for gastric varices, an important clinical question remains: should endoscopists inject glue into every visible varix, or restrict injection to those considered high risk (e.g. with stigmata of recent hemorrhage [SRH])? The randomized controlled trial (RCT) by Prajapati et al. published in this issue of Endoscopy provides the first head-to-head comparison of these two strategies in patients experiencing their first variceal bleed [1].
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Marine Camus (2025) studied this question.
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