Material Composition of Esophageal Variceal Bands
Esophageal variceal bands are made of elastic rubber material, specifically small elastic "O" rings designed for endoscopic ligation. 1, 2
Technical Specifications
The bands used in endoscopic variceal ligation (EVL) are:
- Standard rubber elastic bands that function as small "O" rings applied via specialized endoscopic devices 1, 2
- Latex-free elastic materials in modern formulations to avoid allergic reactions 3
- Applied using multi-band ligator devices (such as the Wilson-Cook Multi-Band Ligator SAEED SixShooter) that can deploy multiple bands sequentially during a single endoscopic session 4
Clinical Application Details
The bands work through mechanical strangulation of the varix:
- Each band creates circumferential compression that leads to thrombosis and eventual sloughing of the ligated tissue 2
- Typically 4-5 bands are placed per session on average, with a range of 1-8 bands depending on the extent of varices 5
- The ligated tissue falls off within 10-14 days, leaving shallow ulcers that heal over subsequent weeks 1
- Mean of 3.5 sessions (range 2-8) are required to achieve complete variceal eradication 5
Important Clinical Considerations
Band ligation is the preferred first-line endoscopic treatment for esophageal varices over sclerotherapy due to superior safety profile and comparable efficacy 1. However, for gastric varices—particularly cardiofundal varices—band ligation is less effective than cyanoacrylate injection due to the larger size and deeper location of gastric varices 1.
The elastic bands should not be confused with other endoscopic materials: they are distinct from the polyvinyl or thermoplastic materials used in esophageal dilators 1, and completely different from cyanoacrylate glue used for gastric variceal obturation 1.