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The Baveno VII consensus, released in 2023, recommends that the endoscopic treatment of choice for managing bleeding gastric varices (GV) is endoscopic ultrasound (EUS)-guided treatment, specifically EUS-guided cyanoacrylate (CYA) glue injection. This approach has been endorsed due to its efficacy in controlling bleeding while reducing rebleeding rates, compared to other endoscopic techniques. Despite its efficacy, CYA injection for GV has been linked to rare but serious adverse events, such as glue embolization leading to pulmonary embolism, infection/bacteremia, splenic infarction, intra-procedural and post-procedural complications.

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Background: Treatment of symptomatic varicose veins has changed dramatically in the last few years with guidelines now recommending endovenous surgery as first-line intervention. Previously, this was achieved by laser or radiofrequency ablation of the target vein, requiring infiltration of tumescent anesthesia to reduce the risks of thermal damage to surrounding tissue. Endovenous cyanoacrylate injection (VenaSeal™) is a nonthermal, nontumescent endovenous closure technique, increasing patient comfort and is readily performed under local anesthesia only and thus is a feasible technique for in-room treatment.

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