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Gastroenterology Research and Practice
Volume 2013 (2013), Article ID 865945, 8 pages
http://dx.doi.org/10.1155/2013/865945
Review Article

EUS-Guided Vascular Procedures: A Literature Review

1Department of Gastroenterology, University Hospital Dubrava, Zagreb University School of Medicine, Avenue Gojka Suska 6, 10 040 Zagreb, Croatia
2Rijeka University School of Medicine, Brace Branchetta 20, 51 000 Rijeka, Croatia

Received 22 February 2013; Revised 9 April 2013; Accepted 9 April 2013

Academic Editor: Siyu Sun

Copyright © 2013 Tomislav Bokun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endoscopic ultrasound (EUS) is continuously stepping into the therapeutic arena, simultaneously evolving in different directions, such as the management of pancreatic and biliary diseases, celiac neurolysis, delivering local intratumoral therapy, and EUS-guided endosurgery. EUS-guided vascular procedures are also challenging, considering the variety of vascular pathology, proximity of the vascular structures to the GI tract wall, high resolution, and real-time guidance offering an attractive access route and precise delivery of the intervention. The literature on vascular therapeutic EUS demonstrates techniques for the management of upper GI variceal and nonvariceal bleeding, pseudoaneurysms, and coiling and embolization procedures, as well as the creation of intrahepatic portosystemic shunts. The paucity of studies, diversity of study designs, and the number of animal model studies hamper a systematic approach to the conclusion and decision making important to clinicians and healthcare policy makers. Nevertheless, theoretical benefits and findings up to date concerning technical feasibility, efficacy, and safety of the procedures drive further research and development in this rather young therapeutic arena.