Gastroesophageal Varices: Can Balloon-Compression Sclerotherapy Beat EVL?: JGH | September 2026

What Did the Study Find?

This randomized trial included 124 patients with cirrhosis and gastroesophageal varices. All underwent EUS-guided cyanoacrylate therapy for gastric varices, followed by either balloon-compression EIS (bc-EIS) or EVL for esophageal varices.

Gastric-varix eradication was 100% in both groups.

Esophageal-varix eradication was 100% with bc-EIS vs 82.3% with EVL.

bc-EIS required significantly fewer treatment sessions: 1.4 vs 2.1.

Rebleeding was numerically lower with bc-EIS (9.7% vs 21.0%), but the difference was not statistically significant.

The study therefore demonstrates better variceal eradication efficiency, but not yet a proven reduction in clinically important rebleeding.

Why Does It Matter?

Repeated endoscopic sessions increase treatment burden in patients with portal hypertension. More complete eradication with fewer procedures could be clinically valuable.

GastroAGI Takeaway

For expert centres already performing EUS-guided variceal therapy, bc-EIS is a promising alternative to EVL for accompanying esophageal varices. However, this single-centre trial should not displace EVL as standard practice yet. Multicentre validation and longer-term evidence showing reduced rebleeding are needed.