Could we standardize the injection technique and regimen of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices?

摘要

I read with interest the article by Seewald et al regarding the injection technique and regimen of N-butyl-2-cyanoac-rylate injection for the treatment of gastric fundal varices, and I would like to make some comments. In their article, the investigators show that the prevalence of isolated gastric varices 1 is much higher than that of gastroesophageal varices 2, which is contrary to other studies. Is this related to different etiologies of portal hypertension? Because the outcomes were excellent in the study by Seewald et al,1 did the investigators enroll all patients with fundal varices or were they selective? For example, in my experience, the prognosis is dismal in patients with advanced hepatocellular carcinoma and portal vein thrombosis.