Left atrial appendage thrombus detected by transesophageal examination with linear endoscopic ultrasound

Ikezawa, Kenji; Shigekawa, Minoru; Sengoku, Kaoruko; Yoshioka, Teppei; Sakamori, Ryotaro; Sakata, Yasushi; Takehara, Tetsuo

doi:10.1002/ccr3.2223

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Endoscopic biliary stenting is mainly performed for the assessment of pancreaticobiliary and mediastinal diseases. [15][16][17] EUS(-FNA) has been considered a safe examination in patients with biliary stricture, [2][3][4][5] but the risk of post-EUS cholangitis has not attracted much attention. To the best of our knowledge, this study is the first report on post-EUS cholangitis.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic biliary stenting as the risk factor for cholangitis after endoscopic ultrasound in patients with biliary strictures

Ikezawa

Shigekawa

Yamai

et al. 2020

J of Gastro and Hepatol

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Background and Aim Endoscopic ultrasound (EUS) and EUS‐guided fine needle aspiration (FNA) are established as efficient and safe diagnostic modalities. However, the risk of cholangitis after EUS/EUS‐FNA (post‐EUS cholangitis) in patients who have biliary strictures has not been fully examined. Methods We retrospectively reviewed 136 consecutive inpatients with biliary strictures who received EUS/EUS‐FNA at our hospital from April 2012 to September 2017 and evaluated complications that occurred by the next day after EUS/EUS‐FNA. Patients with percutaneous biliary drainage, those in whom it was difficult to reach the duodenum, and those receiving concurrent endoscopic retrograde cholangiopancreatography were excluded. Results We included 121 patients (147 cases); 90 patients were malignant. Endoscopic biliary stenting (EBS) with plastic stents had already been performed in 86 cases. Post‐EUS cholangitis was observed in 4.1% (6/147). No other EUS‐related complications were observed. The incidence of cholangitis with EBS was significantly higher than that in the cases without EBS (7.0% [6/86] vs 0% [0/61], P = 0.042). Biliary enzyme elevation was also identified as a risk factor of cholangitis. Conclusion Endoscopic biliary stenting was identified as a risk factor associated with post‐EUS cholangitis in patients with biliary strictures. Endoscopists should pay attention to post‐EUS cholangitis, especially in cases with EBS and biliary enzyme elevation.

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Section: Discussionmentioning

confidence: 99%

Endoscopic biliary stenting as the risk factor for cholangitis after endoscopic ultrasound in patients with biliary strictures

Ikezawa

Shigekawa

Yamai

et al. 2020

J of Gastro and Hepatol

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“…We collected general and clinical information, including age, gender, history of smoking, drinking and chronic diseases, CHA 2 DS 2 -VASc score, AF types, results of blood tests, measured parameters of transthoracic echocardiography (TE) and TEE, from medical records in the hospital system. LAAT was defined as abnormal lumpy echogenic masses of LAA seen in ≥2 sections with clear boundaries using TEE [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation

et al. 2021

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Objective To investigate the risk factors of left atrial appendage thrombus (LAAT) in patients with non-valvular atrial fibrillation (AF). Methods We collected the clinical data of patients with non-valvular AF who underwent transesophageal echocardiography (TEE) at the Zhongda Hospital of Southeast University between January 2016 and June 2019. The patients were divided into two groups, LAAT and non-LAAT. We performed comparative analysis, receiver operating characteristic (ROC) curve analysis and logistic regression analysis to estimate the risk factors of LAAT. Results A total of 442 patients with non-valvular AF were enrolled in the study. LAAT was detected by TEE in 20 cases (4.7%). Compared with patients without LAAT, patients with LAAT had higher CHA2DS2-VASc scores (3 vs 2, p = 0.001), higher values of D-dimer (180.0 vs 90.0 μg/L, p = 0.003), larger LA anteroposterior diameters (50.5 vs 41.0 mm, p < 0.001) and higher ratios of non-paroxysmal AF (85.0% vs 23.6%, p < 0.001). ROC curve analysis revealed that the cutoff value of LA anteroposterior diameter was 49.5 mm. After adjusting for other confounders, logistic regression analysis showed that enlarged LA (anteroposterior diameter ≥49.5 mm) and non-paroxysmal AF were independently associated with higher risks of LAAT (OR = 7.28, 95% CI: 2.36–22.47; OR = 8.89, 95% CI: 2.33–33.99, respectively). The proportions of LAAT in patients with larger LA (anteroposterior diameter ≥49.5 mm), non-paroxysmal AF and both larger LA and non-paroxysmal AF were 30% (12/40), 15.2% (17/112) and 39.1% (9/23), respectively. Conclusion Enlarged LA (anteroposterior diameter ≥49.5 mm) and non-paroxysmal AF were independent risk factors of LAAT in non-valvular AF patients.

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“…Endoscopic ultrasound (EUS) is primarily used to evaluate pancreatobiliary and mediastinal diseases 16 17 18 . EUS-guided FNA (EUS-FNA) has been established as an accurate method of tissue acquisition and is performed in a wide variety of patients with PC, including those who have unresectable disease 19 20 .…”

Section: Introductionmentioning

confidence: 99%

Establishment of organoids using residual samples from saline flushes during endoscopic ultrasound-guided fine-needle aspiration in patients with pancreatic cancer

et al. 2022

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Background and study aims In patients with pancreatic cancer (PC), patient-derived organoid cultures can be useful tools for personalized drug selection and preclinical evaluation of novel therapies. To establish a less invasive method of creating organoids from a patient’s tumor, we examined whether PC organoids can be established using residual samples from saline flushes (RSSFs) during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Methods Five patients with PC who underwent EUS-FNA were enrolled in a prospective study conducted at our institution. RSSFs obtained during EUS-FNA procedures were collected. An organoid culture was considered as established when ≥ 5 passages were successful. Organoid-derived xenografts were created using established organoids. Results EUS-FNA was performed using a 22- or 25-gauge lancet needle without complications. Patient-derived organoids were successfully established in four patients (80.0 %) with the complete medium and medium for the selection of KRAS mutants. Organoid-derived xenografts were successfully created and histologically similar to EUS-FNA samples. Conclusions Patient-derived PC organoids were successfully established using EUS-FNA RSSFs, which are produced as a byproduct of standard manipulations, but are usually not used for diagnosis. This method can be applied to all patients with PC, without additional invasive procedures, and can contribute to the development of personalized medicine and molecular research.

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Left atrial appendage thrombus detected by transesophageal examination with linear endoscopic ultrasound

Cited by 4 publications

References 19 publications

Endoscopic biliary stenting as the risk factor for cholangitis after endoscopic ultrasound in patients with biliary strictures

Endoscopic biliary stenting as the risk factor for cholangitis after endoscopic ultrasound in patients with biliary strictures

Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation

Establishment of organoids using residual samples from saline flushes during endoscopic ultrasound-guided fine-needle aspiration in patients with pancreatic cancer

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