Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Table 2 Existing literature on endoscopic ultrasound-guided vascular interventions for gastric varices

Ref.	Cases	Treatment used in EUS	EUS needle size	Number of coils (EUS only)	Use of Glue/others (mL) (EUS/endoscopic therapy)	Number of sessions (EUS/endoscopic)	Technical success (%)	Clinical success (%)	Adverse events (overall) (%)	Reintervention rates (%)	Rebleeding rates (%)	All-cause mortality (%)
Studies on only EUS-guided Glue injection
Lee et al[39], 2000	54	CYA (0.5 mL) with lipiodol (0.7 mL)	-	-	3 (1-8)	2.2 ± 1.7	52/54 (96.3%)	43/54 (79.6%)	22/54 (40.7%)	-	19/54 (35.2%)	28/54 (51.9%)
Romero-Castro et al[23], 2007	5	CYA-lipiodol (1 mL; 1:1)	22-G	-	1.6 (1-2)	2 cases: 1 each; 3 cases: 2 each	100%	100%	None	-	None	20%
Gubler and Bauerfeind[40], 2014	40	CYA-lipiodol (1 mL; 1:1)	22-G	-	1.9 (1-10)	1.4 (1-7)	40/40 (100%)	36/36 (100%)	2/40 (5%)	6/40 (15%)	-	6/40 (15%)
Studies on only EUS-guided coil injection
Romero-Castro et al[25], 2010	4	Coils	19-G	Each case: 22; 7; 3; 2	-	-	100%	3/4 (75%)	None	-	None	25%
Khoury et al[41], 2018	10	Coils	19-G	4.5 (mean)	-	2.8 (mean)	100%	complete (20%); near-complete (50%)	5 cases (minimal self-limited bleeding); 1 case needing blood transfusion	30% (3/10)	1 case (10%)	None
Studies on only EUS-guided coil + glue injection
Binmoeller et al[42], 2011	30	Coil + 1 mL CYA	19-G	-	1.4 (1-4)	1	30/30 (100%)	23/24 (95.8%)	None	1/30 (3.3%)	4/24 (16/6%)	1/30 (3.3%)
Bhat et al[27], 2015	152	Coil + 1 mL CYA	19/22-G	1.4 (1-4)	2 (0.5-6)	-	151/152 (99.3%)	93/100 (93%)	9/124 (7%)	7/125 (5.6%)	20/125 (16%)	3/151 (1.98%)
Kozieł et al[43], 2019	16	Coil + CYA (1:1 with lipiodol)	19-G	Total 21; mean 1.7 (1-3)	2 (1-9)	-	15/16 (94%)	Overall, 12/15 (75%) {coil+CYA (11/12 [92%]; only CYA [0%]}	6/16 (37.5%)	5/16 (31.3%)	1/16 (6.25%)	None
Robles-Medranda et al[44], 2019	30	Coil + CYA	19-G	2 (1-3)	1.8 (1.2-2.4 mL)	Mean 1.1	100%	96.6%	2 cases (6.7%)	3/27 (11.1%)	5 (16.7%)	4/30 (13.3%)
Kouanda et al[28], 2021	80	Coil + CYA	-	1.5 (1-3)	2 (0.5-5) mL	Mean 1.4	100%	60/62 (96.7%)	4 (4.9%)		6 (7.5%)	17 (21.3%)
Comparison of different treatment modalities for GV management
Romero-Castro et al[26], 2013	30	EUS-Coil (11) vs EUS-CYA (19)	19/22-G	5.8 (2-13) (overall 64 coils)	1.5 (1-3) (overall 29 mL)	Overall, 1.4 ± 0.1 (14 vs 29)	Overall, 27/30 (90%): 10/11 (90.9%) vs 17/19 (89.5%)	Overall, 29/30 (96.7%): 10/11 (90.9%) vs 19/19 (100%)	Overall, 12/30 (40%): 1/11 (9.1%) vs 11/19 (57.9%)	2/11 (18.1%) vs 9/19 (47.3%)	None (0 vs 0)	Overall, 6/30 (20%)
Bick et al[45], 2018	104	EUS-CYA (64) vs endoscopic CYA (40)	19/22-G	-	2 (0.8) vs 3.3 (1.3) mL	1 session (79% vs 75%); 2 sessions (21% vs 17.5%); 3 sessions (0% vs 7.5%)	100% vs 100%	49/64 (79%) vs 30/40 (75%)	13/64 (20.3%) vs 7/40 (17.5%)	-	5/57 (8.8%) vs 9/38 (23.7%)	-
Mukkada et al[32], 2018	81	EUS-coil +/- CYA (30) vs endoscopic CYA (51)	19-G	2.36 (mean) (total 71)	2 (1-10 mL) in 15 cases vs 3 ± 1.5 ml	Overall [42 vs 77]	100% vs 100%	8/20 (40%) vs (NA)	0% vs 0%	12/30 (40%) vs 26/51 (51%)	6/30 (20%) vs 26/51 (51%)	3/30 (10%) vs 2/51 (4%)
Robles-Medranda et al[29], 2019	60	EUS-coil + CYA (30) vs EUS-coil (30)	19-G	2 (1-3) vs 3 (1-7)	1.8 (1.2-2.4) vs -	-	100% vs 100%	30/30 (100%) vs 27/30 (90%)	2 (6.7%) vs 1 (3.3%)	5 (16.7%) vs 12 (40%)	1 (3.3%) vs 6 (20%)	9/30 (30%) vs 8/30 (26.7%)
Lôbo MRA et al[33], 2019	32	EUS-coil + CYA (16) vs endoscopic CYA (16)	19-G	Total 21	1.4 ± 0.74 vs 3.07 ± 1.94	Overall, 20 vs 18	100% vs 100%	11 (73.3%) vs 12 (75%)	8 (50%) vs 10 (62.5%)	4/15 (26.7%) vs 4/16 (25%)	2 (12.5%) vs 2 (12.5%)	0 (0%) vs 2 (12.5%)
Bazarbashi et al[46], 2020	40	EUS-coil + AGS (10) vs EUS/endoscopic CYA/histocryl (30)	19/22-G	8 ± 2.9	1.7 ± 2.9	-	10/10 (100%) vs 29/30 (96.7%)	100% vs 87%	1/10 (10%) vs 5/30 (20%)	1/10 (10%) vs 17/20 (56%)	0% vs 38%	1/10 (10%) vs 5/30 (16.6%)
Robles-Medranda et al[31], 2021	36	EUS-coil + CYA (17) vs endoscopic CYA (19)	19-G	0 vs 2 (1-3)	1.8 (1.2-2.4) vs 1.8 (0.6-6.6)	1 vs 1 (1-4)	17/17 (100%) vs 16/19 (84.2%)	-	2/17 (11.8%) vs 3/19 (15.8%)	-	0 vs 3/19 (15.8%)	-
Seven et al[47], 2022	28	EUS-coil (19) vs EUS-coil + CYA (9)	19-G	5 (3-9) vs 5 (3-9)	-	1 vs 1	19/19 (100%) vs 9/9 (100%)	19/19 (100%) vs 8/9 (88.9%)	1/19 (5.3%) vs 1/9 (11.1%)	1/19 (5.3%) vs 0/9 (0%)	1/19 (5.3%) vs 22.2%)	6/28 (21.42%)
Samanta et al[34], 2022 (Author’s centre)	170	EUS-coil+CYA (52) vs endoscopic CYA (118)	19-G	Median 2	2 (1) vs 2 (1) mL	1 (0) vs 2 (2)	52 (100%) vs 117 (99.2%)	-	0% vs 13.9%	7 (13.5%) vs 58 (49.6%)	8 (15.4%) vs 36 (31.3%)	-
Studies on EUS-guided treatment of GV using agents other than glue
Frost and Hebbar[36], 2017	8	Thrombin (1000 IU/5 mL; 2500 IU/5 mL)	22-G	-	For active bleeder: mean 7250 IU; for elective: mean 2520 IU	1 for each case	100% overall	Overall, 75% (active bleeder: 67%; elective cases: 80%)	None	None	None	1 case
Bazarbashi et al[37], 2019	10	Coil + AGS	19/22-G	8 ± 2.9	AGS: 2.5 ± 0.7	1 each	100%	9/9 (100%)	None	None	1/10 (10%)	None
Irisawa et al[38], 2020	8	Coil + sclerosant [EO]	19-G	5.6 ± 2.9	EO: 7.8 ± 6.7 mL	1.9 ± 1	100%	7/8 (87.5%)	None	-	-	-

EUS: Endoscopic ultrasound; G: Gauge; CYA: Cyanoacrylate; AGS: Absorbable gelatin sponge; EO: Ethanolamine oleate; IU: International units.