Primary Prevention of Gastric Varices Bleed
Gastric Varices Bleeding, Endoscopic Ultrasound
About this trial
This is an interventional prevention trial for Gastric Varices Bleeding
Eligibility Criteria
Inclusion Criteria: Patients 18 years or older Referred to St. Michael's Hospital (SMH) for esophagogastroduodenoscopy (EGD) screening for varices Patients with GOV-2 or IGV-1 varices with the size ≥ 10 mm Exclusion Criteria: Age >75 and < 18 years Pregnancy Contraindications to beta-blockers and cyanoacrylate injection Prior treatment for prevention of bleeding from patients on beta-blockers Hepatic encephalopathy grade III/IV Hepatorenal syndrome, hepatocellular carcinoma, presence of deep jaundice (serum bilirubin >170 mmol/L) Cardiorespiratory failure Co-existing large oesophageal varices which require endoscopic intervention Child-Pugh C (score of 10-15 indicating decompensated disease) Presence of serious complications of liver cirrhosis
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
EUS-Guided Therapy of glue and coil + Non-selective Beta Blockers (Propanolol)
EUS-Guided Therapy of Glue and Coil
Non-Selective Beta Blockers (Propanolol)
Participants in this arm will receive a daily oral dose of a non-selective beta blocker (Propanolol) and undergo EUS-guided therapy of glue and coil as described in Arms 1 and 2. Participants will be monitored for side effects, complications, and efficacy of both the medication and the procedure.
Participants in this arm will undergo endoscopic ultrasound (EUS) to identify and target gastric varices. Under EUS guidance, a combination of glue and coil will be used to occlude the gastric varices. Participants will be monitored for complications and efficacy of the procedure
Participants in this arm will receive a daily oral dose of a non-selective beta blocker (such as propranolol) for the duration of the study. Participants will be monitored for side effects and efficacy of the medication.