Endoscopic Ultrasound-Guided Vascular Procedures: A Review

Abstract

Since the 1980s, endoscopic ultrasound has advanced from being purely diagnostic to an interventional modality. The gastrointestinal tract offers an exceptional window for assessing the vascular structures in the mediastinum and in the abdomen. This has led to a rapidly growing interest in endoscopic ultrasound-controlled vascular interventions as a minimally invasive alternative to surgical and radiological procedures.

Use of TC-325 Hemostatic Powder as a Rescue Monotherapy for Management of Rectal Variceal Bleed

“…Most often ARVs are visible during a colonoscopy; however, when deep, they might be more challenging to localize and visualize; with that, there is no consensus on how to manage their bleeding. 4 , 9 , 10 In the absence of specific guidelines, physicians have tried many approaches such as mechanical management with balloon tamponade—as a bridging solution to transjugular intrahepatic portosystemic shunt if indicated—however, rebleeding was almost inevitable. 11 , 12 Endoscopic procedures, such as injection sclerotherapy, band ligation, and cyanoacrylate glue injection, have been also explored but resulted in up to a 33% rate of bleeding recurrence.…”

“… 3 Unlike their counterpart, the upper gastrointestinal variceal bleedings (UGIVBs), there have not been any guidelines issued on the management of ARV bleeding. 4 , 5 Even though the use of the endoscopic hemostatic powder TC-325 (Hemospray; Cook Medical, Winston-Salem, NC), was widely reported in the management of UGIVBs, 6 , 7 very limited literature exists with regard to its use for lower gastrointestinal bleedings (LGIBs) and specifically for nonvariceal LGIBs (NVLGIBs). 6 , 8 In this report, we present a rare case of rectal varices bleeding that was controlled by the use of TC-325 as a rescue and monotherapy agent.…”

Endoscopic ultrasound-guided vascular interventions: An overview of current and emerging techniques

“…CTCs are promising new biomarkers in cases of solid tumors, especially in pancreatic cancer, and could be utilized for molecular testing, clinical prediction of future hepatic metastasis, and drug sensitivity analyses. 30 In a single-center cohort study, blood samples aspirated from PV with a 19-gauge FNA needle under EUS guidance and peripheral blood samples were collected from 18 patients with suspected pancreatobiliary tumors. CTCs were detected in PV samples in all 18 patients (100%), whereas they were detected in peripheral blood samples of only four patients (22.2%).…”