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For more than 15 years, the tissue glue cyanoacrylate (n-butyl-2-cyanoacrylate) has been successfully used in Europe and many other countries, but not in the United States, for the treatment of bleeding gastric varices. The use of cyanoacrylate for the treatment of esophageal and gastric varices via the percutaneous transhepatic route, was first described by Lundequist et al. 1. Endoscopic injection of the tissue glue for gastric variceal bleeding was first reported in 1986 2. Due to its excellent efficacy 3 4 5 6 7 8 9 10 11 12 13 14 cyanoacrylate is considered to be the optimal initial therapy for gastric variceal bleeding by many clinicians worldwide, with the exception of the US. In Europe, cyanoacrylate has recently been approved for endoscopic use (Glubran®; GEM, Viareggio, Italy).
Seewald et al. (Fri,) studied this question.