EUS-Guided Vascular Procedures: A Literature Review

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Vascular Medicine

Background:

• Endoscopic ultrasound (EUS) is expanding beyond diagnostics into therapeutic applications.
• EUS offers precise, real-time guidance for interventions near gastrointestinal structures.
• Therapeutic EUS applications include pancreatic/biliary diseases, neurolysis, and endosurgery.

Purpose of the Study:

• To review the current literature on therapeutic EUS-guided vascular procedures.
• To assess the feasibility, efficacy, and safety of EUS in vascular interventions.
• To identify challenges and future directions in this emerging field.

Main Methods:

• Systematic review of existing literature on therapeutic EUS vascular interventions.
• Analysis of techniques for managing upper GI variceal/nonvariceal bleeding, pseudoaneurysms, and portosystemic shunts.
• Evaluation of studies focusing on coiling, embolization, and other vascular procedures.

Main Results:

• EUS-guided vascular procedures demonstrate technical feasibility for various pathologies.
• Reported applications include management of bleeding, pseudoaneurysms, and intrahepatic portosystemic shunt creation.
• Challenges include study design diversity and a paucity of clinical data, with many studies using animal models.

Conclusions:

• Therapeutic EUS for vascular interventions shows theoretical benefits and promising initial findings.
• Technical feasibility, efficacy, and safety are being established in this developing area.
• Further research is crucial for clinical decision-making and healthcare policy development.