Interventional endoscopic ultrasound

Abstract

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.

A Transesophageal Cardiovascular Intervention

“… 10 The list of indications has rapidly expanded to include drainage procedures (peripancreatic collections and biliary drainage), injections (celiac plexus neurolysis and bleeding control), targeted destruction of lesions (fiducial placement for radiation therapy and alcohol ablation), guidance of transluminal endoscopic surgery, and vascular intervention (vascular coil insertion and vascular access). 11 - 13 Risks and complications of EUS include perforation, sedation-related problems (anaphylactic reaction to anesthetic drugs, respiratory depression with cardiovascular collapse, and aspiration pneumonia), and bleeding from iatrogenic vascular injuries. Puncture or biopsy-related infections are rare.…”

History of contrast enhanced ultrasound (CEUS)

“…The shape of the urinary tract and a potential backflow of urine during micturition can be assessed. Percutaneous nephrostomy [86], biliary tract imaging via percutaneous transhepatic cholangiography and drainage (PTCD) [87][88][89][90] or via endoscopic retrograde cholangiography (ERCP) [91,92], as well as an oral CEUS swallow for imaging Zenker's diverticulum [93] have been described and of proven utility in select case studies.…”

Efficacy of a Novel Tapered Contrast Catheter for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Multicenter Study

“…Percutaneous transhepatic biliary drainage (PTBD) has previously been performed as an alternative to ERCP; however, it has a high rate of adverse events (AEs) [ 3 ]. Recently, Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been widely performed instead of PTBD, and the efficacy of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has been described in previous reports [ 4 , 5 , 6 ]. Although a high success rate of EUS-HGS has been reported [ 7 ], comprehensive identification and analysis of risk factors for AEs remain an area of ongoing research.…”