Initial evaluation of a novel, prototype, forward-viewing echoendoscope in a porcine arterial bleeding model (with video)

Elmunzer, B. Joseph; Pollack, Michael J.; Trunzo, Joseph A.; Schomisch, Steve J.; Wong, Richard C.K.; Faulx, Ashley L.; Isenberg, Gerard; Ponsky, Jeffrey L.; Marks, Jeffrey M.; Chak, Amitabh

doi:10.1016/j.gie.2010.04.053

Cited by 8 publications

(7 citation statements)

References 11 publications

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“…1). Two papers reported about non-human preliminary experience with the FV echoendoscope, in a porcine and a phantom model, respectively 1622. Another paper was a clinical review on the initial experience with the FV echoendoscope 23.…”

Section: Resultsmentioning

confidence: 99%

Forward-view endoscopic ultrasound: A systematic review of diagnostic and therapeutic applications

2013

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Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) and therapeutic procedures have been performed by a curved linear array (CLA) echoendoscope since the early 1990's. This particular echoendoscope, allowing real time visualization of aspiration needles and of other devices, has substantially remained unchanged since its introduction to the market. In a context of rapidly expanding indications for EUS-guided procedures, a dedicated forward view (FV) echoendoscope has been developed and tested under different clinical conditions. The FV echoendoscope is equipped with front endoscopic and EUS view, allowing deployment of needles and other devices through the working channel in straight direction. Several new diagnostic and therapeutic applications may thereby potentially be feasible with the FV echoendoscope and the established ones may prove easier to accomplish. The published literature with the FV echoendoscope has been systematically reviewed and the results are presented analytically and discussed in detail. EUS-FNA and therapeutic procedures, including pancreatic pseudocyst drainage, treatment of gastric fundal varices, celiac plexus neurolysis, and duct drainage were reported. The FV echoendoscope showed some unique advantages, opening new possibilities such as EUS-FNA in difficult gastrointestinal tracts and combined endoscopic/EUS treatment with frontal approach. However, no statistically significant evidence of superiority of the FV echoendoscope vs. the CLA echoendoscope was found in pancreatic pseudocyst drainage. No complications specifically attributable to the use of the FV echoendoscope were reported.

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Section: Resultsmentioning

confidence: 99%

Forward-view endoscopic ultrasound: A systematic review of diagnostic and therapeutic applications

2013

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“…After endosonographic visualization of submucosal artery, dilute epinephrine injection or contact thermal coagulation were delivered directly to the vessel through the working channel of the forward-viewing echoendoscope under direct EUS guidance. The procedure was successful in both cases treated with epinephrine injection and in two out of four treated with contact thermal coagulation [17]. Gonzalez et al successfully treated a patient who bled from the side branch of gastroduodenal artery with EUS-guided injection of cyanoacrylate, with no recurrence bleeding detected during 14-month followup [18].…”

Section: Resultsmentioning

confidence: 99%

EUS-Guided Vascular Procedures: A Literature Review

Bokun

Grgurević

Kujundžić

et al. 2013

Gastroenterology Research and Practice

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Endoscopic ultrasound (EUS) is continuously stepping into the therapeutic arena, simultaneously evolving in different directions, such as the management of pancreatic and biliary diseases, celiac neurolysis, delivering local intratumoral therapy, and EUS-guided endosurgery. EUS-guided vascular procedures are also challenging, considering the variety of vascular pathology, proximity of the vascular structures to the GI tract wall, high resolution, and real-time guidance offering an attractive access route and precise delivery of the intervention. The literature on vascular therapeutic EUS demonstrates techniques for the management of upper GI variceal and nonvariceal bleeding, pseudoaneurysms, and coiling and embolization procedures, as well as the creation of intrahepatic portosystemic shunts. The paucity of studies, diversity of study designs, and the number of animal model studies hamper a systematic approach to the conclusion and decision making important to clinicians and healthcare policy makers. Nevertheless, theoretical benefits and findings up to date concerning technical feasibility, efficacy, and safety of the procedures drive further research and development in this rather young therapeutic arena.

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“…7 The potential for use in a porcine arterial bleeding model has been investigated. 8 This instrument may also be useful in visualizing hepatic hilar biliary strictures, a region that is often hard to localize with the linear echoendoscope. 9 There is published experience using the FV-CLA in the colon.…”

Section: Discussionmentioning

confidence: 99%