■在门脉高压中,已知胃静脉曲张相关出血有更高的输血需求,不受控制的出血,再出血,重症监护病房的要求,和死亡。在胃静脉曲张的情况下,EUS引导的线圈插入现在是内窥镜治疗的可接受方式。通过这项研究,我们讨论了在胃静脉曲张中使用EUS进行线圈和胶水注射的大型单中心经验。我们还研究了与使用这种方式作为初级预防和抢救治疗相关的不良事件和可能性。
■该研究是在印度的三级护理中心进行的。共有86名患者被纳入研究。EUS引导线圈和胶水的适应症分为3种临床情况,即,重新流血,救援,和主要。技术上的成功和临床上的成功,也就是说,控制患者的出血,通过EUS上没有多普勒信号证实,内窥镜视图,稳定血红蛋白,不需要输血维持血红蛋白。
■平均Child-Turcotte-Pugh评分和终末期肝病模型-Na评分分别为9.2和14.6。胃静脉曲张的平均大小为18.9mm。使用的线圈的平均数为2.9,并且所需的胶的平均量为1.6mL。整个患者组的技术成功率为100%。在90%的患者组中观察到临床成功。平均随访时间为175.2天。
■EUS引导的线圈和胶水疗法在不同的临床设置中都有作用,作为主要治疗,重新流血,和抢救治疗。它具有显著的技术和临床成功。它在治疗算法中的作用需要在前瞻性研究中进一步研究。与介入放射学主导的干预相比,它可以提供成本优势。
UNASSIGNED: In portal hypertension, gastric varix-associated bleeding is known to have higher transfusion requirements, uncontrolled bleeding, rebleeding, intensive care unit requirements, and death. EUS-guided coil insertion is now an acceptable modality for endoscopic management in cases of gastric varices. With this study, we discuss our large single-center experience in the use of EUS for coil and glue injection in gastric varices. We also look into adverse events associated with and possibilities of using this modality as both primary prophylaxis and a rescue therapy.
UNASSIGNED: The study was conducted in a tertiary care center in India. A total of 86 patients were included in the study. The indication for EUS-guided coil and glue was divided into 3 clinical situations, namely, rebleed, rescue, and primary. The technical success and clinical success, that is, control of bleed in patients, were confirmed by absence of Doppler signal on EUS, endoscopic view, and stabilized hemoglobin with no need of blood product transfusion to maintain hemoglobin.
UNASSIGNED: The mean Child-Turcotte-Pugh score and Model for End-Stage Liver Disease-Na score were 9.2 and 14.6, respectively. The mean size of the gastric varices was 18.9 mm. The mean number of coils used was 2.9, and the average quantity of glue required was 1.6 mL. The technical success was 100% across the patient group. Clinical success was seen in 90% of the patient group. Mean follow-up was seen for 175.2 days.
UNASSIGNED: EUS-guided coil and glue therapy has a role in different clinical settings, as primary therapy, rebleed, and rescue therapy. It has significant technical and clinical success. Its role in treatment algorithms needs to be further studied in prospective studies. It may offer a cost advantage in comparison to interventional radiology-led interventions.