Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature

Angelis, C.G. De; Valdivia, Pablo Cortegoso; Rizza, Stefano; Venezia, Ludovica; Rizzi, Felice; Gesualdo, M.; Saracco, Giorgio Maria; Pellicano, Rinaldo

doi:10.3390/jcm9030866

Cited by 17 publications

(8 citation statements)

References 37 publications

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“…Currently, the role of EUS for the management of NVB is more of a rescue therapy. However, a recent systematic review reported a favourable outcome of EUS-guided therapy in 91.4% of cases[ 83 ]. In addition, EUS-angiotherapy is feasible and safe for managing Dieulafoy’s lesion, bleeding ulcer or tumour, GI stromal tumour (GIST) and sometimes, visceral artery pseudoaneurysms (PsA).…”

Section: Eus-guided Management Of Non-variceal Gi Bleedmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Dhar¹,

Samanta²

2023

World J Gastrointest Endosc

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Endoscopic ultrasound (EUS) has expanded its arena from a mere diagnostic modality to an essential therapeutic tool in managing gastrointestinal (GI) diseases. The proximity of the GI tract to the vascular structures in the mediastinum and the abdomen has facilitated the growth of EUS in the field of vascular interventions. EUS provides important clinical and anatomical information related to the vessels' size, appearance and location. Its excellent spatial resolution, use of colour doppler with or without contrast enhancement and ability to provide images “real-time” helps in precision while intervening vascular structures. Additionally, structures such as venous collaterals or varices can be dealt with optimally using EUS. EUS-guided vascular therapy with coil and glue combination has revolutionized the management of portal hypertension. It also helps to avoid radiation exposure in addition to being minimally invasive. These advantages have led EUS to become an upcoming modality to complement traditional interventional radiology in the field of vascular interventions. EUS-guided portal vein (PV) access and therapy is a new kid on the block. EUS-guided portal pressure gradient measurement, injecting chemotherapy in PV and intrahepatic portosystemic shunt has expanded the horizons of endo-hepatology. Lastly, EUS has also forayed into cardiac interventions allowing pericardial fluid aspiration and tumour biopsy with experimental data on access to valvular apparatus. Herein, we provide a comprehensive review of the expanding paradigm of EUS-guided vascular interventions in GI bleeding, portal vein access and its related therapeutic interventions, cardiac access, and therapy. A synopsis of all the technical details involving each procedure and the available data has been tabulated, and the future trends in this area have been highlighted.

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Section: Eus-guided Management Of Non-variceal Gi Bleedmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Dhar¹,

Samanta²

2023

World J Gastrointest Endosc

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“…Data on EUS-guided treatment of nonvariceal gastrointestinal bleeding remain scarce. Alcohol, polidocanol, cyanoacrylate or thrombin injection have been reported in case series of bleeding Dieulafoy's lesions [117], gastrointestinal stromal tumours (malignant) ulcers and pancreatic pseudoaneurysms. Although this technique has been around for 25 years, there is insufficient evidence to support inclusion of the procedure in evidence-based algorithms for gastrointestinal bleeding therapy.…”

Section: Endoscopic Ultrasound-guided Angiotherapymentioning

confidence: 99%

Interventional endoscopic ultrasound

Dietrich

Braden

Jenssen

2021

Current Opinion in Gastroenterology

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Purpose of review To update on recent advances in interventional endoscopic ultrasound (INVEUS) techniques. Recent findings The introduction of linear echoendoscopes with larger instrument channels and the combined development of new tools and devices have enabled various new applications of minimally invasive endoscopic ultrasound (EUS)-guided transluminal interventions of the pancreas, biliary system and peri-gastrointestinal structures. In this review, EUS-guided interventions are discussed and evaluated: drainage of peripancreatic fluid collections, access and drainage of bile ducts, gallbladder and pancreatic duct, treatment of gastrointestinal haemorrhage, coeliac plexus block and coeliac plexus neurolysis, fiducial placement, solid and cystic tumour ablation, drug delivery and brachytherapy, gastroenterostomy, angiotherapy and other EUS-guided applications. The EUS-guided interventions are classified based on the available evidence as established or experimental, standardized or nonstandardized procedures in common or rare diseases with well or little known complications and their established or nonestablished treatment. Summary Some EUS-guided interventions have sparse published evidence with only single-centre studies, case series or individual case reports, others like drainage of peripancreatic fluid collections have become widely accepted practice. INVEUS has been accepted as an alternative to several surgical approaches, EUS-guided techniques result in faster recovery times, shorter hospital stay and lower costs.

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“…The efficacy of EUS-guided therapy of nonvariceal upper gastrointestinal bleeding has been described. Series have been published with success rates of 88 %–100 % for the treatment of Dieulafoy’s lesions, pancreatic/gastroduodenal artery pseudoaneurysms, gastrointestinal stromal tumors, periampullary tumors, duodenal ulcers, and intractable marginal ulcers after Roux-en-Y gastric bypass 2 3 4 . To our knowledge, EUS-guided lauromacrogol injection for the treatment of refractory gastric cancer bleeding has not been reported in this setting.…”

Section: Endoscopy E-videosmentioning

confidence: 99%