Primary Prophylaxis of Gastric Varix Bleed

This study has been completed.
Information provided by:
Govind Ballabh Pant Hospital Identifier:
First received: May 19, 2009
Last updated: May 20, 2009
Last verified: May 2009

In patients who have never bled from gastric varix (GOV2 and IGV1), cyanoacrylate injection will be better than both beta-blocker therapy and no treatment in prevention of gastric variceal bleed. The investigators conducted a randomized controlled trial in patients with gastric varix (GOV2 and IGV1) who never bled before, to study the efficacy of treatment with cyanoacrylate injection versus beta-blocker versus no treatment in prevention of first bleed from gastric varices.

Condition Intervention
Procedure: Endoscopic cyanoacrylate injection
Drug: Beta-blocker (propranolol)

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
Official Title: A Randomized Controlled Trial Comparing Cyanoacrylate Injection Versus Beta-Blockers Versus No Treatment for Primary Prophylaxis of Gastric Variceal Bleed

Resource links provided by NLM:

Further study details as provided by Govind Ballabh Pant Hospital:

Primary Outcome Measures:
  • Bleeding from gastric varix or death [ Time Frame: Within 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Increase or decrease in the size of gastric varices, appearance of new esophageal varices and appearance or worsening of portal hypertensive gastropathy (PGP), complications [ Time Frame: Within 2 years ] [ Designated as safety issue: Yes ]

Enrollment: 74
Study Start Date: August 2006
Study Completion Date: January 2009
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Endoscopic Cyanoacrylate injection
Endoscopic injection of cyanoacrylate in the gastric varix until obturation
Procedure: Endoscopic cyanoacrylate injection
Endoscopic cyanoacrylate injection in gastric varix
Other Name: Glue injection in gastric varix
No Intervention: No Intervention
No treatment offered for gastric varix
Beta-blocker (propranolol)
Beta-blocker (propranolol) was started at a dose of 20 mg twice daily. The principle of incremental dosing was used to achieve the target heart rate for propranolol. The dose was increased every alternate day to achieve a target heart rate of 55/min or to the maximal dose to 360 mg/day if the medication was well tolerated and the systolic blood pressure was > 90 mm Hg. On the occurrence of intolerable adverse effects, systolic blood pressure < 90 mm Hg or pulse rate < 55/min, the dose of the medication was decreased step-wise, and eventually stopped if these adverse events persisted. Reintroduction of the medication was attempted if cessation of the medication did not result in improvement of the reported side-effect.
Drug: Beta-blocker (propranolol)

Detailed Description:

Patients are followed up every 3 months or at the time of end point or complications.


Ages Eligible for Study:   12 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients with GOV2 with eradicated esophageal varix or IGV1, who had never bled from gastric varix were included.

Exclusion Criteria:

  • Only esophageal varix, GOV1 with GOV2, acute bleed or past history of bleed from gastric varix, contraindications to beta-blocker therapy and cyanoacrylate injection.
  • Prior injection of cyanoacrylate or sclerotherapy or variceal ligation or transjugular intrahepatic portosystemic shunt or balloon-occluded retrograde transvenous obliteration or balloon-occluded endoscopic injection sclerotherapy of gastric varix for prevention of bleeding from GV
  • Patients already on beta-blocker or nitrates
  • Undetermined origin of bleeding from esophageal varix or gastric varix
  • Hepatic encephalopathy grade III/IV
  • Hepatorenal syndrome
  • Hepatocellular carcinoma
  • Presence of deep jaundice (serum bilirubin > 10 mg/dl)
  • Uremia
  • Cerebrovascular accident
  • Cardiorespiratory failure
  • Pregnancy and patients not giving informed consent for endoscopic procedures
  Contacts and Locations
Please refer to this study by its identifier: NCT00905996

Shiv K Sarin
New Delhi, Delhi, India, 110002
Sponsors and Collaborators
Govind Ballabh Pant Hospital
Principal Investigator: Shiv K Sarin, MD, DM G B Pant Hospital, New Delhi, India
  More Information

No publications provided by Govind Ballabh Pant Hospital

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Dr S K Sarin, Department of Gastroenterology, G B Pant Hospital, New Delhi, India Identifier: NCT00905996     History of Changes
Other Study ID Numbers: SRM04
Study First Received: May 19, 2009
Last Updated: May 20, 2009
Health Authority: India: Ministry of Health

Additional relevant MeSH terms:
Liver Cirrhosis
Liver Diseases
Digestive System Diseases
Pathologic Processes
Adrenergic beta-Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Anti-Arrhythmia Agents
Cardiovascular Agents
Therapeutic Uses
Antihypertensive Agents
Vasodilator Agents processed this record on April 17, 2014