Targeting the perforator vein: EUS-guided coil embolization for the treatment of bleeding rectal varices

Bazarbashi, Ahmad Najdat; Thompson, Christopher C.; Ryou, Marvin

doi:10.1016/j.vgie.2020.05.008

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…Rectal varices are a well-recognized complication of portal hypertension[ 36 ]. The perforator vein supplies the variceal circulation, which invaginates superficially and bleeds.…”

Section: Ectopic Varicesmentioning

confidence: 99%

“…The perforator vein supplies the variceal circulation, which invaginates superficially and bleeds. Common treatment options include interventional radiology and surgery with a mortality rate documented as high as 80%[ 36 ]. Well regarded recommendation in a previous study showed that the injection 2 mL of N-butyl 2-CYA into the varix, thrombosed the collaterals and bleeding subsided in 2 wk[ 37 ].…”

Section: Ectopic Varicesmentioning

confidence: 99%

“…Well regarded recommendation in a previous study showed that the injection 2 mL of N-butyl 2-CYA into the varix, thrombosed the collaterals and bleeding subsided in 2 wk[ 37 ]. In attempts to further reduce conventional interventional radiology mortality rates in the treatment of rectal varices, a study suggested the added benefit of EUS-guided treatment that provides an overall better diagnostic approach and higher technical success in targeting the perforator vein directly thus achieving homeostasis with less coils and hence overall less AE rates[ 36 ].…”

Section: Ectopic Varicesmentioning

confidence: 99%

See 2 more Smart Citations

Role of endoscopic ultrasound in vascular interventions: Where are we now?

Fugazza¹,

Khalaf²,

Colombo³

et al. 2022

WJGE

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From a mere diagnostic tool to an imperative treatment modality, endoscopic ultrasound (EUS) has evolved and revolutionized safer efficient options for vascular interventions. Currently it is an alternative treatment option in the management of gastrointestinal bleeding, primarily variceal type bleeding. Conventional treatment option prior to EUS incorporation had limited efficiency and high adverse events. The characterization and detail provided by EUS gives a cutting edge towards a holistically successful management choice. Data indicates that EUS-guided combination therapy of coil embolization and glue injection has the higher efficacy for the treatment of varices. Conversely, similar treatment options that exist for esophageal and other ectopic variceal bleeding was also outlined. In conclusion, many studies refer that a combination therapy of coil and glue injection under EUS guidance provides higher technical success with fewer recurrence and adverse events, making its adaptation in the guideline extremely favorable. Endo-hepatology is a novel disciple with a promising future outlook, we reviewed topics regarding portal vein access, pressure gradient measurement, and thrombus biopsy that are crucial interventions as alternative of radiological procedures. The purpose of this review is to provide an update on the latest available evidence in the literature regarding the role of EUS in vascular interventions. We reviewed the role of EUS in variceal bleeding in recent studies, especially gastric varices and novel approaches aimed at the portal vein.

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“…Rectal varices are a well-recognized complication of portal hypertension[ 36 ]. The perforator vein supplies the variceal circulation, which invaginates superficially and bleeds.…”

Section: Ectopic Varicesmentioning

confidence: 99%

Section: Ectopic Varicesmentioning

confidence: 99%