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Clin Endosc. 2017 Mar;50(2):138-142. doi: 10.5946/ce.2017.048. Epub 2017 Mar 30.

Endoscopic Ultrasound-Guided Vascular Therapy: The Present and the Future.

Clinical endoscopy

Philip S J Hall, Christopher Teshima, Gary R May, Jeffrey D Mosko

Affiliations

  1. The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, ON, Canada.

PMID: 28391673 PMCID: PMC5398359 DOI: 10.5946/ce.2017.048

Abstract

Endoscopic ultrasound (EUS) offers access to many intra-abdominal vessels that until now have only been accessible to the surgeon and interventional radiologist. In addition to assisting with diagnostics, this unique access offers the potential for therapeutic intervention for a host of indications. To date, this has had the most clinical impact in the treatment of gastroesophageal varices, with EUS-guided coil and glue application growing in use worldwide. Although randomised controlled trial data is lacking, we discuss the growing body of literature behind EUS-guided therapy in the management of varices. EUS has also been used in specialized centres to assist in non-variceal gastrointestinal bleeding. The treatment of bleeding from Dieulafoy lesions, tumours and pancreatic pseudoaneurysms has all been described. The potential applications of EUS have also extended to the placement of portal vein stents and porto-systemic shunts in animal models. As medicine continues to move to increasingly less invasive interventions, EUS-guided therapies offer substantial promise for the safe and effective delivery of targeted treatment for a widening array of vascular disorders.

Keywords: Endosonography; Esophageal and gastric varices; Portal pressure

References

  1. Gastrointest Endosc. 2000 Oct;52(4):455-62 - PubMed
  2. Am J Gastroenterol. 2008 Feb;103(2):352-9 - PubMed
  3. Clin Gastroenterol Hepatol. 2016 Sep;14(9):1234-44 - PubMed
  4. Hepatogastroenterology. 1996 Sep-Oct;43(11):1250-5 - PubMed
  5. Hepatol Res. 2009 Feb;39(2):126-33 - PubMed
  6. Gastrointest Endosc. 2008 Mar;67(3):572-4 - PubMed
  7. Endoscopy. 2012 May;44(5):539-42 - PubMed
  8. Am J Gastroenterol. 2016 Jul;111(7):925 - PubMed
  9. Endosc Ultrasound. 2016 Sep-Oct;5(5):315-319 - PubMed
  10. Gastrointest Endosc. 2001 Jan;53(1):77-84 - PubMed
  11. Gastrointest Endosc. 2016 Jun;83(6):1164-72 - PubMed
  12. Gut. 2015 Nov;64(11):1680-704 - PubMed
  13. Gastrointest Endosc. 1996 Sep;44(3):257-61 - PubMed
  14. Gastrointest Endosc. 2014 Jun;79(6):1007-8; discussion 1008 - PubMed
  15. Hepatology. 1992 Dec;16(6):1343-9 - PubMed
  16. Gastrointest Endosc. 2000 Aug;52(2):168-74 - PubMed
  17. Gastrointest Endosc. 2009 Apr;69(4):941-7 - PubMed
  18. Gastrointest Endosc. 2006 Mar;63(3):396-402; quiz 463 - PubMed
  19. Gastrointest Endosc. 2000 Mar;51(3):331-3 - PubMed
  20. J Res Med Sci. 2015 Dec;20(12):1200-7 - PubMed
  21. Gastrointest Endosc. 2013 Nov;78(5):711-21 - PubMed
  22. Gastrointest Endosc. 2007 Aug;66(2):402-7 - PubMed
  23. Gastrointest Endosc. 2011 Nov;74(5):1019-25 - PubMed
  24. Hepatology. 2017 Jan;65(1):310-335 - PubMed
  25. Endoscopy. 2009 Aug;41(8):721-4 - PubMed
  26. Endoscopy. 2010;42 Suppl 2:E35-6 - PubMed
  27. World J Gastrointest Endosc. 2015 Sep 25;7(13):1107-13 - PubMed
  28. Clin Gastroenterol Hepatol. 2015 Apr;13(4):808-12.e1 - PubMed
  29. Gastrointest Endosc. 2012 Oct;76(4):915-6 - PubMed
  30. Gastrointest Endosc. 2010 Nov;72(5):1106-8 - PubMed
  31. J Hepatol. 2011 Jun;54(6):1161-7 - PubMed
  32. World J Gastrointest Surg. 2016 Nov 27;8(11):729-734 - PubMed
  33. Gastrointest Endosc. 2017 Jan;85(1):243-247 - PubMed

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