Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2025; 17(2): 100556
Published online Feb 16, 2025. doi: 10.4253/wjge.v17.i2.100556
Endoscopic ultrasound-guided treatment of isolated gastric varices
Khellaf Amalou, Ryma Rekab, Ahlem Belloula, Khadidja Saidani
Khellaf Amalou, Ryma Rekab, Ahlem Belloula, Khadidja Saidani, Department of Gastroenterology, Mohamed Seghir Nekkache, Algiers 16000, Algeria
Author contributions: Amalou K take responsibility in necessary literature review for the study, in writing of the whole of the article and review it before submission scientifically besides spelling and grammar; Rekab R, Belloula A and Saidani K review the article before submission.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https: //creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Khellaf Amalou, PhD, Assistant Professor, Department of Gastroenterology, Mohamed Seghir Nekkache, Kouba 246, Algiers 16000, Algeria. amalou_kh@yahoo.fr
Received: August 20, 2024
Revised: December 31, 2024
Accepted: January 21, 2025
Published online: February 16, 2025
Processing time: 177 Days and 6.5 Hours
Abstract

In this letter we comment on the article by Zhang et al published in the recent issue of the World Journal of Gastrointestinal Endoscopy 2024. We focus specifically on the management of gastric varices (GV), which is a significant consequence of portal hypertension, is currently advised to include beta-blocker therapy for primary prophylaxis and transjugular intrahepatic portosystemic shunt for secondary prophylaxis or active bleeding. Although it has been studied, direct endoscopic injection of cyanoacrylate glue has limitations, such as the inability to fully characterize GV endoscopically and the potential for distant glue embolism. In order to achieve this, endoscopic ultrasound has been used to support GV characterization, real-time therapy imaging, and Doppler obliteration verification.

Keywords: Gastric varices; Active bleeding; Direct endoscopic injection of cyanoacrylate; Interventional endoscopic ultrasound; Endoscopic ultrasound-guided coil embolization

Core Tip: The primary treatment for isolated gastric varices (IGVs), which have the potential to be harmful, is endoscopic. Treatment guided by endoscopic ultrasonography (EUS) is more accurate than traditional endoscopic therapy. In this situation, EUS-guided coil embolization in combination with cyanoacrylate injection proved to be an effective treatment method for an IGV entangled with an artery. This was a successful treatment for an IGV that was entangled in an artery.