Interventional endoscopic ultrasound: Therapeutic capability and potential

Area of Science:

• Gastroenterology
• Medical Imaging
• Interventional Endoscopy

Background:

• The introduction of the linear echoendoscope in the 1990s revolutionized endoscopic ultrasound (EUS).
• This innovation enabled the development of interventional EUS (IEUS) procedures, expanding its clinical applications beyond diagnostics.

Purpose of the Study:

• To review published data on EUS-guided interventional procedures.
• To summarize the diagnostic capabilities of EUS.
• To elaborate on the therapeutic potential and applications of IEUS.

Main Methods:

• Literature review of published data on EUS-guided interventional procedures.
• Analysis of diagnostic and therapeutic outcomes.

Main Results:

• Tissue acquisition via EUS-guided Fine Needle Aspiration (EUS-FNA) has established high diagnostic quality.
• Therapeutic IEUS procedures include celiac plexus neurolysis/block, drainage of pseudocysts, abscesses, and selected pancreatic/biliary ductal systems.
• EUS-guided fine needle injection for antitumor agent delivery shows promise.

Conclusions:

• IEUS has evolved significantly, offering robust diagnostic and increasingly diverse therapeutic interventions.
• EUS-FNA remains a cornerstone for tissue acquisition, while other IEUS procedures address various clinical challenges.
• The therapeutic potential of IEUS, including targeted drug delivery, continues to expand.