Eus-Guided Treatment of Gastric Fundal Varices With Coil and Glue Injection Is Safe and Fares Better Than Endoscopic Glue Injection: An International Mutli-Centre Experience

Samanta, Jayanta; Nabi, Zaheer; Facciorusso, Antonio; Dhar, Jahnvi; Akbar, Wahid; Birda, Chhagan Lal; Mangiavillano, Benedetto; Auriemma, Francesco; Lakhtakia, Sundeep; Kochhar, Rakesh; Duvvur, Nageshwar R.

doi:10.1016/j.gie.2022.04.1323

Cited by 6 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further randomized trials and meta-analysis also confirmed these findings. 38 39 In a recent multicentric propensity-matched analysis, Samanta et al 40 also showed that EUS-guided therapy with coil and glue is a safe technique with better efficacy and lower rebleeding rate. Interestingly, they also showed that the size of the varix and the technique of therapy were independent predictors of rebleeding.…”

Section: Therapeutic Applications Of Eus In Hepatologymentioning

confidence: 54%

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

Puri,

Sharma,

Dhampalwar

et al. 2023

Journal of Digestive Endoscopy

View full text Add to dashboard Cite

The word endo-hepatology evokes many perceptions. Some believe it to be the emerging new interventional branch and some believe it to be an extension of endoscopy. Nonetheless, it has continued to evolve into an exciting area of active work. With the advent of endoscopic ultrasound (EUS) based procedures, new vistas have opened up. EUS-guided liver biopsies, portal hypertension management, and multiple new procedures are being described. EUS also plays a large role in the management of patients in the peritransplant period. With this review, we present an overview of the role of EUS in the field of hepatology as well as during the peritransplant period and its applications.

show abstract

Section: Therapeutic Applications Of Eus In Hepatologymentioning

confidence: 54%

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

Puri,

Sharma,

Dhampalwar

et al. 2023

Journal of Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…EUS–guided glue injection as monotherapy was performed in 4 studies, [ 23 – 26 ] EUS-coils were deployed as monotherapy in 5 studies, [ 24 , 27 – 30 ] combination EUS-coil + glue was performed in 9 studies, [ 26 , 28 , 30 – 36 ] EUS-guided thrombin injection was used in 1 study, [ 37 ] EUS-guided sclerosant (ethanolamine oleate) injection was used in 1 study [ 38 ] and EUS-guided coils and absorbable hemostatic gelatin sponge were used in 2 studies. [ 39 , 40 ]…”

Section: Resultsmentioning

confidence: 99%

EUS–guided therapies for primary and secondary prophylaxis in gastric varices—An updated systematic review and meta-analysis

Chandan,

Nguyen,

Mohan

et al. 2023

Endosc Ultrasound

View full text Add to dashboard Cite

Background and Objectives Gastric varices (GVs) are associated with a higher risk of uncontrolled bleeding and death when compared with esophageal varices. While endoscopic glue injection therapy has been traditionally used for secondary prophylaxis in GV, data regarding primary prophylaxis continue to emerge. Recently, EUS–guided therapies have been used in GV bleeding. Methods We conducted a comprehensive search of several major databases from inception to June 2022. Our primary goals were to estimate the pooled rates of treatment efficacy, GV obliteration, GV recurrence, and rebleeding with EUS-guided therapy in primary and secondary prophylaxis. Overall adverse events and technical failures were assessed. Random-effects model was used for our meta-analysis, and heterogeneity was assessed using the I 2 % statistics. Results Eighteen studies with 604 patients were included. In primary prophylaxis, pooled rate of GV obliteration was 90.2% (confidence interval [CI], 81.1–95.2; I 2 = 0). With combination EUS–glue and coil therapy, the rate was 95.4% (CI, 86.7%–98.5%; I 2 = 0). Pooled rate of posttherapy GV bleeding was 4.9% (CI, 1.8%–12.4%; I 2 = 0). In secondary prophylaxis, pooled rate of treatment efficacy was 91.9% (CI, 86.8%–95.2%; I 2 = 12). With EUS-glue, EUS-coil, and combination EUS–glue and coil, the rates were 94.3% (CI, 88.9%–97.1%; I 2 = 0), 95.5% (CI, 80.3%–99.1%; I 2 = 0), and 88.7% (CI, 76%–95.1%; I 2 = 14), respectively. Pooled rate of GV obliteration was 83.6% (CI, 71.5%–91.2%; I 2 = 74). With EUS-glue, EUS-coil, and combination EUS–glue and coil, the rates were 84.6% (CI, 75.9%–90.6%; I 2 = 31), 92.3% (CI, 81.1%–97.1%; I 2 = 0), and 84.5% (CI, 50.8%–96.7%; I 2 = 75), respectively. Pooled rates of GV rebleeding and recurrence were 18.1% (CI, 13.1%–24.3%; I 2 = 16) and 20.6% (CI, 9.3%–39.5%; I 2 = 66), respectively. Conclusion Our analysis shows that EUS-guided therapy for GVs is technically feasible and clinically successful in both primary and secondary prophylaxis of GV.

show abstract

“…Comparison of EUS-coil with CYA vs endoscopic glue injection: Limited data exist (retrospective and one RCT) comparing EUS combination therapy vs conventional endoscopic glue injection[ 31 - 34 ]. Robles-Medranda et al [ 31 ] compared the cost-effectiveness of the two procedures and found EUS therapy to be better.…”

Section: Eus-guided Management Of Variceal Bleedmentioning

confidence: 99%

“…The author’s experience of the largest multicenter study involving four centers to evaluate the effectiveness of EUS combination therapy (52 cases) vs endoscopic therapy (118 patients) showed that the EUS arm required a lower number of sessions for complete obliteration (1 vs 2), lower re-bleeding rates (15.4% vs 31.3%) and lower post-procedure abdominal pain (0% vs 13.9%)[ 34 ]. Currently, an RCT is recruiting patients for EUS-guided coil and glue vs endoscopic CYA therapy for GV[ 35 ].…”

Section: Eus-guided Management Of Variceal Bleedmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Dhar¹,

Samanta²

2023

World J Gastrointest Endosc

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Eus-Guided Treatment of Gastric Fundal Varices With Coil and Glue Injection Is Safe and Fares Better Than Endoscopic Glue Injection: An International Mutli-Centre Experience

Cited by 6 publications

References 0 publications

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

EUS–guided therapies for primary and secondary prophylaxis in gastric varices—An updated systematic review and meta-analysis

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Contact Info

Product

Resources

About