| Initial evaluation of a novel, prototype, forward-viewing echoendoscope in a porcine arterial bleeding model (with video). | |
| | |
MedLine Citation:
|
PMID: 20630519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Real-time visualization of submucosal arterial flow at the base of an ulcer might improve endoscopic hemostasis by permitting more accurate assessment of the artery, precise targeting of therapy, and confirmation of vessel ablation. OBJECTIVE: To evaluate the utility of a novel, forward-viewing echoendoscope in identifying bleeding submucosal arteries, guiding hemostatic therapy, and confirming cessation of flow through treated vessels. DESIGN: In 7 pigs, a previously described porcine model for peptic ulcer hemorrhage was created by isolating the gastroepiploic and/or short gastric artery and tunneling it into the subserosal space at laparotomy. SETTING: Animal research facility. INTERVENTION: The prototype endoscope was used to image submucosal arterial flow. EUS guidance was then used to deliver endoscopic hemostatic therapy and assess treatment adequacy. MAIN OUTCOME MEASUREMENTS: Identification of the target submucosal artery and successful delivery of EUS-guided endoscopic therapy, evidenced by cessation of Doppler flow through the target vessel. RESULTS: Tunneled arteries were visualized endosonographically in all 7 cases. EUS-guided submucosal injection of epinephrine was successful in 2 of 2 cases. EUS-guided delivery of thermal hemostatic therapy was successful in 2 of 4 cases. Absence of flow through treated vessels was confirmed in cases in which EUS-guided therapy was successfully delivered. LIMITATIONS: Acute animal model. CONCLUSION: Proof of principle experiments in a porcine peptic ulcer hemorrhage model suggest that real-time sonographic imaging of submucosal arteries is feasible with a forward-viewing echoendoscope, and guided hemostatic therapy can be delivered. |
| | |
Authors:
|
B Joseph Elmunzer; Michael J Pollack; Joseph A Trunzo; Steve J Schomisch; Richard C Wong; Ashley L Faulx; Gerard A Isenberg; Jeffrey L Ponsky; Jeffrey M Marks; Amitabh Chak |
Related Documents
:
|
7666219 - Severe thrombocytopenia following intraarterial papaverine administration for treatment... 1885979 - Treatment of vasospasm with a 480-nm pulsed-dye laser. 12743639 - Prevention of delayed cerebral vasospasm after aneurysmal subarachnoid hemorrhage. 14174529 - A new instrument for control of hemorrhage by aortic compression. a preliminary report. 11486119 - Vasospasm in monkeys resolves because of loss of and encasement of subarachnoid blood c... 3352019 - Preoperative percutaneous intraluminal balloon catheter control of major arterial hemor... 21646029 - Endovascular stenting of extracranial carotid artery aneurysm: a systematic review. 10972539 - Acute and chronic sympathoinhibition on carotid artery diameter of spontaneously hypert... 10387119 - Management of carotid artery stenosis: a review. |
Publication Detail:
|
Type: Journal Article; Video-Audio Media Date: 2010-07-13 |
Journal Detail:
|
Title: Gastrointestinal endoscopy Volume: 72 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-08-30 Completed Date: 2011-01-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
|
Languages: eng Pagination: 611-4 Citation Subset: IM |
Copyright Information:
|
Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
|
Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA. badihe@umich.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Artifacts Disease Models, Animal* Electrocoagulation / instrumentation Endosonography / instrumentation* Epinephrine / administration & dosage Equipment Design Gastric Mucosa / blood supply, pathology, ultrasonography Gastroepiploic Artery / pathology, surgery, ultrasonography Hemostasis, Surgical / instrumentation* Peptic Ulcer Hemorrhage / pathology, surgery*, ultrasonography* Swine Ultrasonography, Doppler, Color / instrumentation* Ultrasonography, Interventional / instrumentation* Vasoconstrictor Agents / administration & dosage |
| Chemical | |
Reg. No./Substance:
|
0/Vasoconstrictor Agents; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: String capsule endoscopy: a novel application for the preoperative identification of a small-bowel o...
Next Document: Pleural tuberculosis diagnosed by EUS-guided fine-needle tissue acquisition.