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

Gastrointestinal Endoscopy
B Joseph ElmunzerA Chak

Abstract

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. 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. 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. Animal research facility. The prototype endoscope was used to image submucosal arterial flow. EUS guidance was then used to deliver endoscopic hemostatic therapy and assess treatment adequacy. Identification of the target submucosal artery and successful delivery of EUS-guided endoscopic therapy, evidenced by cessation of Doppler flow through the target vessel. 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 ...Continue Reading

References

Nov 5, 2003·Gastrointestinal Endoscopy·Monique E van LeerdamGuido N J Tytgat
Aug 8, 2008·The American Journal of Gastroenterology·B Joseph ElmunzerLoren Laine

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Citations

Jun 6, 2013·Gastroenterology Research and Practice·Tomislav BokunMarko Banic
Apr 1, 2013·Endoscopic Ultrasound·Pietro FusaroliGiancarlo Caletti
Jan 18, 2012·Gastrointestinal Endoscopy·David L DiehlHashem J Hashem
Sep 15, 2012·Clinical Endoscopy·En-Ling Leung Ki, James Y W Lau

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