EUS-Guided Treatment of Gastrointestinal Bleeding
Gastrointestinal (GI) bleeding is one of the most challenging problems that gastroenterologists manage. Conventional therapies for endoscopic hemostasis include epinephrine injection, band ligation, hemoclip placement, and/or thermal therapy. However, there is a subset of patients in whom standard endoscopic hemostatic treatment fails or is unsuitable. Historically, these patients underwent surgical or interventional radiologic therapy to manage the difficult or refractory bleed. Endoscopic ultrasound (EUS)-guided angiotherapy is an emerging and promising treatment modality for select difficult-to-treat bleeding lesions. This chapter highlights novel EUS techniques used to treat patients with challenging GI hemorrhage.
KeywordsEndosonography Vascular Varices Pseudoaneurysm Coil Glue Cyanoacrylate Hemostasis Angiotherapy Gastrointestinal bleeding
Glue and lipiodol were injected under EUS guidance, resulting in complete filling of the variceal network. The glue migrated into the feeding vessel with protection provided by the occlusion balloon to prohibit shunt embolization (MP4 99875 kb)