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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2025; 31(46): 114149
Published online Dec 14, 2025. doi: 10.3748/wjg.v31.i46.114149
Published online Dec 14, 2025. doi: 10.3748/wjg.v31.i46.114149
Gastric varices management: Is clip-assisted glue injection a real-world alternative to endoscopic ultrasound-guided therapy?
Suprabhat Giri, Kshitij Kumar, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Co-first authors: Suprabhat Giri and Kshitij Kumar.
Author contributions: Giri S and Kumar K contributed to the conception and design of the manuscript; Giri S and Kumar K drafted the initial manuscript; Giri S and Kumar K contributed to the critical revision of the initial manuscript; all authors contributed to the literature review, analysis, data collection, and interpretation; all the authors approved the final version of the manuscript. Giri S and Kumar K contributed equally to this work as co-first authors.
Conflict-of-interest statement: The authors declare 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: Suprabhat Giri, Associate Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Kushabhadra Campus, 5, KIIT Rd, Patia, Bhubaneswar 751024, Odisha, India. supg19167@gmail.com
Received: September 15, 2025
Revised: October 19, 2025
Accepted: October 31, 2025
Published online: December 14, 2025
Processing time: 89 Days and 0.6 Hours
Revised: October 19, 2025
Accepted: October 31, 2025
Published online: December 14, 2025
Processing time: 89 Days and 0.6 Hours
Core Tip
Core Tip: Clip-assisted cyanoacrylate injection (clip-ECI) is a safe, effective, and practical method for managing cardiofundal gastric varices, particularly in patients with gastrorenal shunts. Evidence from multicenter cohorts and a randomized trial shows comparable hemostasis to conventional and endoscopic ultrasound (EUS)-guided techniques, with a markedly lower risk of ectopic embolism. By restricting blood flow and improving variceal obliteration, clip-ECI reduces glue migration and often requires fewer sessions. Its shorter procedure time and lower cost make it ideal for centers with limited EUS resources.