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Endoscopic ultrasound-guided vascular interventions: Current insights and emerging techniques
- Source :
- World Journal of Gastroenterology
- Publication Year :
- 2021
- Publisher :
- Baishideng Publishing Group Inc., 2021.
-
Abstract
- Endoscopic ultrasound (EUS) is one of the significant breakthroughs in the field of advanced endoscopy. In the last two decades, EUS has evolved from a diagnostic tool to a real-time therapeutic modality. The luminal gastrointestinal (GI) tract provides a unique opportunity to access multiple vascular structures, especially in the mediastinum and abdomen, thus permitting a variety of EUS-guided vascular interventions. The addition of the doppler and contrast-enhanced capability to EUS has further helped provide real-time visualization of blood flow in vessels through the GI tract. EUS-guided vascular interventions rely on standard endoscopic accessories and interventional tools such as fine-needle aspiration needles and fine-needle biopsy. EUS allows the visualization of various structures in real-time by differentiating tissue densities and vascularity, thus, avoiding radiation exposure. EUS-guided techniques also allow real-time microscopic examination after target biopsy. Furthermore, many necessary interventions can be done during the same procedure after diagnosis. This article provides an overview of EUS-guided vascular interventions such as variceal, non-variceal bleeding interventions, EUSguided portal vein (PV) access with the formation of an intrahepatic portosystemic shunt, and techniques related to diagnosis of GI malignancies. Furthermore, we discuss current insights and future outlook of therapeutic modalities like PV embolization, PV sampling, angiography, drug administration, and portal pressure measurement.
- Subjects :
- Therapeutic endoscopy
Endoscopic ultrasound
medicine.medical_specialty
medicine.medical_treatment
Esophageal varices
Endosonography
medicine
Humans
Portasystemic Shunt, Surgical
Sampling (medicine)
Embolization
Ultrasonography, Interventional
medicine.diagnostic_test
Portal Vein
business.industry
Vascular intervention
Gastroenterology
Gastric varices
Minireviews
General Medicine
medicine.disease
Portal Pressure
digestive system diseases
Endoscopy
Radiology
Portosystemic shunt
business
Subjects
Details
- ISSN :
- 10079327
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- World Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....9a9da6852c8de538d0ccf3ac2c1f90cb