Successful obliteration of bleeding duodenal varices by EUS-guided injection of N -butyl-2-cyanoacrylate

Kimura, Gen; Hashimoto, Yusuke; Ikeda, Masafumi

doi:10.1016/j.vgie.2017.08.001

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Recent advancements in therapeutic EUS have resulted in increased interest in EUS-guided angiotherapy for hemostasis 5, 6. This present case represents an EUS analogue to the CARTO procedure for the management of gastric varices.…”

mentioning

confidence: 89%

Successful EUS-guided treatment of gastric varices with coil embolization and injection of absorbable gelatin sponge

Bazarbashi

Thompson

et al. 2019

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mentioning

confidence: 89%

Successful EUS-guided treatment of gastric varices with coil embolization and injection of absorbable gelatin sponge

Bazarbashi

Thompson

et al. 2019

VideoGIE

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“…EUS plays an important role in determining the exact site, size, and location necessitating targeted therapy. Unfortunately, few case reports exist on using EUS-guided vascular therapy for DV[ 59 - 61 ] (Figure 4 ).…”

Section: Eus-guided Management Of Variceal Bleedmentioning

confidence: 99%

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Dhar¹,

Samanta²

2023

World J Gastrointest Endosc

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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.

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“…EUS-guided approaches using CA injection with our without coils have also been reported, but similar to RVs, no direct comparisons have been made between endoscopic approaches, and therefore making a definitive recommendation based on current data is impossible. 106,107 Case reports of TIPS alone and TIPS with embolization have shown good results in patients with DVs. 108,109 However, in a case series of five patients with bleeding DVs, three already had a TIPS in place and bled despite reduced portosystemic gradients; all five patients required direct obliteration or embolization of the variceal complex.…”

Section: Duodenal Varicesmentioning

confidence: 99%

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

Henry

2020

Digestive Disease Interventions

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Gastric and Ectopic varices are a rare complication of portal hypertension and represent a complex, heterogeneous system of vascular shunts. Bleeding from these shunts can be severe and life-threatening, with poorly standardized treatment algorithms to follow in their management. When bleeding occurs, it is important to follow standard diagnostic procedures for portal hypertensive bleeding and always obtain imaging of the underlying vascular anatomy to help guide therapy. Potential treatment methods will depend on these imaging findings as well as the location of the varix within the gastrointestinal tract. While gastric varices have more data to support specific treatment options, duodenal and rectal varices have only case reports and case series to guide their care. In addition, stomal varices are a very rare complication of portal hypertension and have limited data to support any one treatment modality. Gastric and ectopic varices are best approached in a multidisciplinary fashion after discussion with hepatologists and interventional radiologists to overcome the uncertainty in choosing a definitive therapy.

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Successful obliteration of bleeding duodenal varices by EUS-guided injection of N -butyl-2-cyanoacrylate

Cited by 7 publications

References 9 publications

Successful EUS-guided treatment of gastric varices with coil embolization and injection of absorbable gelatin sponge

Successful EUS-guided treatment of gastric varices with coil embolization and injection of absorbable gelatin sponge

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Management of Gastric and Ectopic Varices: The Endoscopist's Perspective

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