EUS-guided therapy of gastric varices (with video)

Robles-Medranda, Carlos; Oleas, Roberto; Valle, Raquel del; Binmoeller, Kenneth F.

doi:10.4103/eus.eus_55_20

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Data indicates that EUS-guided combination therapy of coil embolization and glue injection has the higher efficacy for the treatment of varices. Similarly, another interesting study reported that although combined therapy had a superior safety profile over EUS-guided CYA injection, when compared to EUS coil injection similar results were obtained[ 29 ]. However, an interesting notion to point out is that coil embolization is technically demanding when compared EUS- guided glue injection[ 14 ].…”

Section: Gastric Varicesmentioning

confidence: 78%

“…Standard therapy for gastric varices by current guidelines recommends the use of endoscopic cyanoacrylate (CYA)[ 29 ]. High bleeding rates and fatal AEs mandates the need for a more feasible option such as EUS guided.…”

Section: Gastric Varicesmentioning

confidence: 99%

“…High bleeding rates and fatal AEs mandates the need for a more feasible option such as EUS guided. EUS-guided therapy provides high technical success and an overall better safety profile[ 24 , 29 ]. Romero-Castro et al [ 30 ] in a retrospective analysis that aimed at a direct comparison of the variable EUS-guided methods showed similar obliteration rated of gastric varices in both CYA injection and coil embolization (Table 1 ).…”

Section: Gastric Varicesmentioning

confidence: 99%

“…Moreover, the combination of EUS-coil/CYA had a lower recurrence rate than their singular respective modalities. The combination modality had lower rebleeding rate and frequency of AE than EUS-CYA[ 29 , 32 ]. Data indicates that EUS-guided combination therapy of coil embolization and glue injection has the higher efficacy for the treatment of varices.…”

Section: Gastric Varicesmentioning

confidence: 99%

“…EUS further provides an advantage in the use of CYA injection in the obliteration of gastric varices as an overall lower mean volume of the glue is needed to reach similar technical success with the same safety profile of rebleeding rates being (8.8% vs 23.7%)[ 32 ]. One study mentioned less incidence of pulmonary embolism for EUS guided coil embolization when compared to EUS CYA therapy[ 29 ]. Coil based therapy for the treatment of gastric varices was reported to be superior to traditional endoscopic therapy with CYA injection[ 16 ].…”

Section: Gastric Varicesmentioning

confidence: 99%

See 4 more Smart Citations

Role of endoscopic ultrasound in vascular interventions: Where are we now?

Fugazza¹,

Khalaf²,

Colombo³

et al. 2022

WJGE

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From a mere diagnostic tool to an imperative treatment modality, endoscopic ultrasound (EUS) has evolved and revolutionized safer efficient options for vascular interventions. Currently it is an alternative treatment option in the management of gastrointestinal bleeding, primarily variceal type bleeding. Conventional treatment option prior to EUS incorporation had limited efficiency and high adverse events. The characterization and detail provided by EUS gives a cutting edge towards a holistically successful management choice. Data indicates that EUS-guided combination therapy of coil embolization and glue injection has the higher efficacy for the treatment of varices. Conversely, similar treatment options that exist for esophageal and other ectopic variceal bleeding was also outlined. In conclusion, many studies refer that a combination therapy of coil and glue injection under EUS guidance provides higher technical success with fewer recurrence and adverse events, making its adaptation in the guideline extremely favorable. Endo-hepatology is a novel disciple with a promising future outlook, we reviewed topics regarding portal vein access, pressure gradient measurement, and thrombus biopsy that are crucial interventions as alternative of radiological procedures. The purpose of this review is to provide an update on the latest available evidence in the literature regarding the role of EUS in vascular interventions. We reviewed the role of EUS in variceal bleeding in recent studies, especially gastric varices and novel approaches aimed at the portal vein.

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Section: Gastric Varicesmentioning

confidence: 78%

Section: Gastric Varicesmentioning

confidence: 99%