Kouanda A, Binmoeller K, Hamerski C, et al. - In this single center observational study, researchers tested the safety and effectiveness of endoscopic ultrasound (EUS)-guided coil and and cyanoacrylate (CYA) injection (EUS-CCI) for the primary prophylaxis of gastric variceal bleeding (GVB). The sample consisted of adult patients with high-risk GV (size > 10 mm or cherry-red spot) without prior bleeding who had EUS-CCI (endoscopic ultrasound-guided coil and cyanoacrylate injection) for the primary prophylaxis of GVB between June 2009 and December 2019. Participants in the study were 80 patients with a mean variceal size of 22.5 ± 9.4 mm and a mean length of follow-up 3.0 ± 2.4 years. EUS-CCI for primary prophylaxis is highly effective at preventing GVB with a low incidence of adverse effects in patients with high-risk GV. In centers with the requisite experience, primary prophylaxis of high-risk GV with coil and CYA glue injection should be considered. In 100% of patients, technical success was achieved, and 96.7% had EUS confirmation of GV obliteration; 67.7% were obliterated with one treatment session. In 2 (2.5%) patients post-treatment GVB was seen, while adverse events were seen in 4 (4.9%) patients.