Xiong YY, Li DW, Zhou TY, Ma H, Gao JG, Shen Z, Xu CF, Yu CH. Clip-assisted endoscopic cyanoacrylate injection vs endoscopic ultrasound-guided coil and cyanoacrylate injection for gastric varices: A propensity score-matched study. World J Gastroenterol 2025; 31(38): 111363 [PMID: 41112012 DOI: 10.3748/wjg.v31.i38.111363]
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08549003
Submitted on:
October 20, 2025, 04:22
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Reader Comments:
I want to congratulate Yang-Yang Xiong for publishing an excellent study comparing Endoscopic Clip or EUS Coil-assisted glue for gastric varices. The authors have shown that EUS-guided therapy is more costly and involves high operating time; however, it has similar technical eradication of gastric varices and re-bleeding rates even in larger varices > 4 cm. The size comparison may not be uniform, as the Endoscopic group measured by endoscopic appearance, which may be as accurate as EUS measurement. The Authors have shown only a 5-day rebleeding rate; adding delayed rates could have been more impactful. There is a discrepancy in the table and image regarding post-injection ulcer; the Image shows a post-glue ulcer in both groups, whereas in the table, it was zero; these typographical errors could have been avoided. The eradication time frame is not mentioned; whether it is immediately or 5 days, as the rebleeding rate or any other time frame is not clear. The Follow up endoscopy data is not given; if done even after CT showing eradication of varices or for other GI Bleeding, the time at which it was done was not mentioned, and the procedure done when eradication is not established is also not given. Despite these limitations the study has provided a meaning ful comparison and can change my practice