EUS-Guided Vascular Procedures: A Literature Review

Bokun, Tomislav; Grgurević, Ivica; Kujundžić, Milan; Banić, Marko

doi:10.1155/2013/865945

Cited by 11 publications

(8 citation statements)

References 53 publications

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“…The higher recurrence is most likely due to failure to treat perforating and collateral vessels. Echoendoscope provides benefits over endoscope due to its ability to visualize and target these high-risk vessels under direct visualization[ 10 , 11 ]. EUS-guided sclerotherapy for esophageal varices was first described in 2000 by Lahoti et al [ 12 ] in a study of 5 patients.…”

Section: Role Of Eus In the Management Of Gi Bleedingmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

Mann¹,

Goyal²,

Perisetti³

et al. 2021

WJG

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Endoscopic ultrasound (EUS) is one of the significant breakthroughs in the field of advanced endoscopy. In the last two decades, EUS has evolved from a diagnostic tool to a real-time therapeutic modality. The luminal gastrointestinal (GI) tract provides a unique opportunity to access multiple vascular structures, especially in the mediastinum and abdomen, thus permitting a variety of EUS-guided vascular interventions. The addition of the doppler and contrast-enhanced capability to EUS has further helped provide real-time visualization of blood flow in vessels through the GI tract. EUS-guided vascular interventions rely on standard endoscopic accessories and interventional tools such as fine-needle aspiration needles and fine-needle biopsy. EUS allows the visualization of various structures in real-time by differentiating tissue densities and vascularity, thus, avoiding radiation exposure. EUS-guided techniques also allow real-time microscopic examination after target biopsy. Furthermore, many necessary interventions can be done during the same procedure after diagnosis. This article provides an overview of EUS-guided vascular interventions such as variceal, non-variceal bleeding interventions, EUSguided portal vein (PV) access with the formation of an intrahepatic portosystemic shunt, and techniques related to diagnosis of GI malignancies. Furthermore, we discuss current insights and future outlook of therapeutic modalities like PV embolization, PV sampling, angiography, drug administration, and portal pressure measurement.

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Section: Role Of Eus In the Management Of Gi Bleedingmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

Mann¹,

Goyal²,

Perisetti³

et al. 2021

WJG

View full text Add to dashboard Cite

show abstract

“…High resolution, proximity of vascular pathology to the gastrointestinal tract wall, and real-time guidance offer precise delivery of the intervention. To date, various EUS-guided vascular therapies have been identified such as EUS-guided management of nonvariceal gastrointestinal bleeding, variceal bleeding, pseudoaneurysm, embolization of the portal venous system, and creation of portosystemic shunts [14].…”

Section: Outcomementioning

confidence: 99%

“…EUS-guided thrombin injection is another possible approach, especially in patients where the established management procedure is not possible. High resolution and realtime guidance by EUS offer an attractive access route and precise delivery of the intervention [14]. Thrombin is the principal enzyme of hemostasis.…”

Section: Outcomementioning

confidence: 99%

Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms

Maharshi

Sharma

et al. 2020

Endosc Int Open

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Background and study aims Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guided thrombin injection for pseudoaneurysms. Patients and methods This prospective study was conducted in our department between January and December 2018. All patients with symptomatic visceral artery pseudoaneurysms, who were unable to undergo angioembolization, were enrolled consecutively. Data related to demography, laboratory parameters, radiological imaging, pseudoaneurysms, and endotherapy were analyzed. Results Eight patients with median age 34 years (27–58 years), all men, were studied. The vessel involved was the splenic artery in 5 patients (62.5 %), the left hepatic artery in 2 (25 %), and the gastroduodenal artery in 1 patient (12.5%). The median size of the pseudoaneurysms was 2.9 cm × 2.6 cm (range, 1.8 × 1.9–4 × 5 cm). The median thrombin requirement was 400 IU (range, 200–500 IU) for loss of Doppler flow signals. EUS after 3 months showed obliterated pseudoaneurysms in 7 patients (87.5 %), while recurrence was observed in 1 patient (12.5 %) after 6 weeks. Conclusions EUS-guided thrombin injection may be a new option for the management of pseudoaneurysms.

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“…New EUS-guided maneuvers have been reported for the management of upper GIT variceal and non-variceal bleeding, pseudo-aneurysm control, coil application and also embolization procedures, as well as the creation of intrahepatic portosystemic shunts and endoprostheses placement. However, these studies are in their early stages and a much research in the near future is expected [54,55] .…”

Section: Eus-guided Vascular Interventionsmentioning

confidence: 99%

Endoscopic ultrasound in gastroenterology: From diagnosis to therapeutic implications

Mekky

Abbas

2014

WJG

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Since its advent in 1980, the scope of endoscopic ultrasound (EUS) has grown to include a wide range of indications, and it is now being incorporated as an integral part of everyday practice in the field of gastroenterology. Its use is extending from an adjuvant imaging aid to utilization as a therapeutic tool for various gastrointestinal disorders. EUS was first used to visualize remote organs, such as the pancreas and abdominal lymph nodes. When fine needle aspiration was introduced, the indications for EUS expanded to include tissue sampling for diagnostic purposes. At the same time, the needle can be used to convey a potential therapy to the internal organs, allowing access to remote sites. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in the field of gastroenterology.

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EUS-Guided Vascular Procedures: A Literature Review

Cited by 11 publications

References 53 publications

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques

Endoscopic ultrasound-guided thrombin injection, a management approach for visceral artery pseudoaneurysms

Endoscopic ultrasound in gastroenterology: From diagnosis to therapeutic implications

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