Tags

Type your tag names separated by a space and hit enter

A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy.
Eur J Gastroenterol Hepatol. 2018 12; 30(12):1411-1415.EJ

Abstract

BACKGROUND

Gastric varices (GV) manifest in almost one-fifth of the patients with portal hypertension. Although primary pharmacological prevention of esophageal varices has been identified, there are limited therapeutic options that are optimal for GV bleeding. Recently, the use of endoscopic ultrasound (EUS)-guided angiotherapy [cyanoacrylate (CA) and coils] was introduced for the treatment of GV. Although CA injection is the recommended first-line therapeutic modality, it is associated with systemic, life-threatening embolization as well as technical instrumental challenges. Recently, EUS-guided coiling for GV was used with high safety profile.

METHODS

This is a review of the current literature on the treatment of GV, focusing on the role of EUS-guided angiotherapy in the treatment of GV. We performed a Medline/PubMed search, and 37 relevant studies were extracted and examined.

RESULTS

EUS-guided angiotherapy has shown a consistent favorable result among the several reports throughout the literature, with better safety and efficacy profile toward EUS-guided coiling; however, a combination treatment with EUS-guided coiling followed by glue injection has shown as well to reduce the embolization adverse events associated with glue injection.

CONCLUSION

EUS-guided angiotherapy and specifically EUS-guided coiling is an emerging promising technique and should be considered as a first-line therapeutic option for bleeding GV.

Authors+Show Affiliations

Department of Internal Medicine. Liver Unit, Department of Gastroenterology, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel.Internal Medicine Department, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29985209

Citation

Khoury, Tawfik, et al. "A Review Article On Gastric Varices With Focus On the Emerging Role of Endoscopic Ultrasound-guided Angiotherapy." European Journal of Gastroenterology & Hepatology, vol. 30, no. 12, 2018, pp. 1411-1415.
Khoury T, Nadella D, Wiles A, et al. A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy. Eur J Gastroenterol Hepatol. 2018;30(12):1411-1415.
Khoury, T., Nadella, D., Wiles, A., Marshall, C., Kumar, M., Shapira, G., Ludvik, N., Schumann, A., Mahamid, M., & Mizrahi, M. (2018). A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy. European Journal of Gastroenterology & Hepatology, 30(12), 1411-1415. https://doi.org/10.1097/MEG.0000000000001200
Khoury T, et al. A Review Article On Gastric Varices With Focus On the Emerging Role of Endoscopic Ultrasound-guided Angiotherapy. Eur J Gastroenterol Hepatol. 2018;30(12):1411-1415. PubMed PMID: 29985209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy. AU - Khoury,Tawfik, AU - Nadella,Divya, AU - Wiles,Alex, AU - Marshall,Caitlin, AU - Kumar,Manoj, AU - Shapira,Gilad, AU - Ludvik,Nicholas, AU - Schumann,Alan, AU - Mahamid,Mahmud, AU - Mizrahi,Meir, PY - 2018/7/10/pubmed PY - 2019/3/7/medline PY - 2018/7/10/entrez SP - 1411 EP - 1415 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 30 IS - 12 N2 - BACKGROUND: Gastric varices (GV) manifest in almost one-fifth of the patients with portal hypertension. Although primary pharmacological prevention of esophageal varices has been identified, there are limited therapeutic options that are optimal for GV bleeding. Recently, the use of endoscopic ultrasound (EUS)-guided angiotherapy [cyanoacrylate (CA) and coils] was introduced for the treatment of GV. Although CA injection is the recommended first-line therapeutic modality, it is associated with systemic, life-threatening embolization as well as technical instrumental challenges. Recently, EUS-guided coiling for GV was used with high safety profile. METHODS: This is a review of the current literature on the treatment of GV, focusing on the role of EUS-guided angiotherapy in the treatment of GV. We performed a Medline/PubMed search, and 37 relevant studies were extracted and examined. RESULTS: EUS-guided angiotherapy has shown a consistent favorable result among the several reports throughout the literature, with better safety and efficacy profile toward EUS-guided coiling; however, a combination treatment with EUS-guided coiling followed by glue injection has shown as well to reduce the embolization adverse events associated with glue injection. CONCLUSION: EUS-guided angiotherapy and specifically EUS-guided coiling is an emerging promising technique and should be considered as a first-line therapeutic option for bleeding GV. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/29985209/A_review_article_on_gastric_varices_with_focus_on_the_emerging_role_of_endoscopic_ultrasound_guided_angiotherapy_ L2 - https://doi.org/10.1097/MEG.0000000000001200 DB - PRIME DP - Unbound Medicine ER -