Wire-guided and endoscopic-guided transesophageal echocardiographic probe insertion.
Ontology highlight
ABSTRACT:
SUBMITTER: Tang SJ
PROVIDER: S-EPMC7222028 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Wire-guided and endoscopic-guided transesophageal echocardiographic probe insertion.
Tang Shou-Jiang SJ Naga Yehia M YM Roebuck Tellie T Sabharwal Aditya A Patel Kruti K Fox Ervin E
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20200211 5
Similar Datasets
Project description: Not available
| S-EPMC7581639 | biostudies-literature
Project description:ObjectivesEndoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an alternative to duodenal stenting and surgical GJ (SGGJ) in malignant gastric outlet obstruction (MGOO). European Society of Gastrointestinal Endoscopy guidelines restricted EUS-GJ for MGOO only, because of misdeployment. The aim was to evaluate its outcomes focusing on benign indications.MethodsThis was a retrospective study conducted from 2016 to 2023 in a tertiary center. Patients included had malignant or benign GOO indicated for EUS-GJ. Techniques were the direct approach until August 2021, and the wire endoscopic simplified technique (WEST) afterwards. The main objective was to compare outcomes in benign vs. MGOO. Secondary end-points were technical success, adverse events rates, and describing the evolution of techniques and indications.ResultsIn all, 87 patients were included, 46 men, mean age 66 ± 16.2 years. Indications were malignant in 60.1% and benign in 39.1%. The EUS-GJ technique was direct in 33 patients (37.9%) and WEST in 54 (62.1%). No difference was found in terms of technical, clinical, or adverse events rates. The initial technical success rate was 88.5%. The final technical and clinical success rates were 96.6% and 94.25%, respectively. In the last year, benign exceeded malignant indications (70.4% vs. 29.6%, P < 0.05). Seven misdeployments occurred, six being addressed with the rescue technique. The misdeployment rate was significantly decreased using the WEST approach compared to the direct one: 3.7% vs. 18% (P < 0.05). The severe postoperative adverse events rate was 2.3%.ConclusionThis study demonstrated similar outcomes of EUS-GJ between benign and MGOO, with a decreasing misdeployment rate (<4%) applying WEST. This represents an additional step towards recommending EUS-GJ in benign indications.
| S-EPMC11808632 | biostudies-literature
Project description:ObjectiveThis meta-analysis aimed to compare videolaryngoscope (VL)-assisted transesophageal echocardiography (TEE) probe insertion with conventional methods in terms of efficacy and safety.MethodsSeveral major databases such as Medline and Embase were systematically searched to identified relevant studies from inception to June 2024. The primary outcome was complication rate, defined as the proportion of patients experiencing complications related to TEE probe insertion. Injuries at specific sites (e.g., posterior hypopharyngeal wall) from both groups were also analyzed. The secondary outcomes included the first-attempt success rate and total insertion time of VL and conventional methods.ResultsSeven trials involving 716 participants were identified. The use of VL was found to significantly reduce the complication rate (risk ratio[RR]:0.28, 95% confidence interval[CI]:0.17-0.46, P < 0.00001) and increased the first-attempt success rate [FASR] (RR:1.33, 95%CI: 1.10-1.60, P = 0.003) compared with conventional methods. These findings were confirmed by trial sequential analysis. No significant difference was found in the TEE insertion time among the two techniques (mean difference: -2.94s, 95%CI: -10.28-4.4, P = 0.43). VL significantly reduced the risk of trauma to the hypopharyngeal wall but showed no significant benefits in other areas (e.g., pyriform sinus). The certainty of evidence was moderate for the complication rate, very low for the FAS rate, and low for the TEE insertion time.ConclusionThe use of VL for TEE probe insertion is associated with a significantly lower complication rate and higher FAS rate than conventional methods. These findings suggest that VL enhances patient safety and improves the efficiency of TEE probe insertion.
| S-EPMC11466393 | biostudies-literature
Project description:Hydatid cyst (HC) is a human parasitic disease caused by the larval stage of Echinococcus granulosus. Cardiac involvement is rare and occurs in 0.5%-2% of patients with hydatid cyst, but isolated pericardial hydatid cyst is rarer still. We present two cases of isolated pericardial hydatid cyst who presented with precordial chest pain and dyspnea. In both the cases, HC were diagnosed by transthoracic echo (TTE), Computed Tomography/Magnetic Resonance and positive hydatid serology. Intraoperatively transesophageal echo (TEE) revealed unilocular transitional cystic lesion the transverse pericardial sinus in one case and multilobulated active cystic lesion in another. The report highlights the role of TEE in diagnosis and evaluation of cardiac HC. Both the cases underwent surgical resection followed by albendazole therapy to prevent recurrence.
| S-EPMC3770108 | biostudies-literature
Project description:ObjectivesAlthough endoscopic papillectomy is useful for treating papillary tumors, it is associated with a high rate of complications including pancreatitis; therefore, safer treatment options are needed. We examined the utility of wire-guided endoscopic papillectomy by comparing the pancreatic duct stenting and pancreatitis rates before and after wire-guided endoscopic papillectomy was introduced at our institution.MethodsWe retrospectively examined the data from 16 consecutive patients who underwent conventional endoscopic papillectomy between November 1995 and July 2005 and the data from 33 patients in whom wire-guided endoscopic papillectomy was first attempted at our institution between August 2005 and April 2017. We compared the pancreatic duct stenting and pancreatitis rates between the two groups.ResultsOf the 33 patients in whom wire-guided endoscopic papillectomy was first attempted, the procedure was completed in 21. Pancreatic duct stenting was possible in 30 of the 33 patients in whom wire-guided endoscopic papillectomy was attempted (91%), and this rate was significantly higher than that before the introduction of wire-guided endoscopic papillectomy (68.8%). The incidence of pancreatitis before the introduction of wire-guided endoscopic papillectomy was 12.5%, but after August 2005, the incidence was reduced by half to 6.1%, which includes those patients in whom wire-guided endoscopic papillectomy could not be completed.ConclusionsAlthough wire-guided endoscopic papillectomy cannot be completed in some patients, we believe that this method shows some potential for reducing the total incidence of post-endoscopic papillectomy pancreatitis owing to more successful pancreatic duct stenting.
| S-EPMC6343902 | biostudies-literature
Project description:We present a case of mitral valve (MV) replacement that resulted in multiple complications, as diagnosed by transesophageal echocardiography (TEE), including left ventricular outflow tract obstruction, aortic dissection and left ventricular rupture. We also describe that identification of bleeding originating from the posterior aspect of the heart by the surgical team should trigger a complete TEE evaluation for adequate diagnosis. An 84-year-old woman underwent a MV replacement. Weaning from cardiopulmonary bypass (CPB) revealed a late-peaking gradient of 44 mmHg over the left ventricular outflow tract caused by obstruction from a bioprosthetic strut. After proper surgical correction, TEE evaluation showed a type A aortic dissection that was subsequently repaired. After separation from CPB, the surgical team identified a major bleed that originated from the posterior aspect of the heart. Although the initial suspicion was injury to the atrioventricular groove, a complete TEE evaluation confirmed a left ventricular free wall rupture by showing the dissecting jet using colour-flow Doppler. TEE is an essential component in cardiac surgery for assessment of surgical repair and potential complications. Posterior bleeding should trigger a complete TEE examination with assessment of nearby structures to rule out a life-threatening pathology. Left ventricular free wall rupture can be identified using colour-flow Doppler.Multiple complications may occur after MVR.TEE is an essential component in the evaluation of surgical repair and its potential associated complications, including LVOT obstruction, aortic dissection and LV rupture.Posterior bleeding, from the region of AV groove, should trigger a complete TEE examination with assessment of nearby structures such as the atria, coronary sinus and myocardium to rule out a life threatening pathology.The diagnosis of a LV rupture can be confirmed with 2-D imaging and colour-flow Doppler demonstrating a dissecting jet through the myocardium.
| S-EPMC4676443 | biostudies-other
Project description:Background and objectiveTransesophageal endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) is a feasible and well-tolerated modality that is increasingly used to diagnose intrathoracic lesions. This narrative review summarizes the current application of EUS-B-FNA for diagnosing lung cancer, thoracic sarcoidosis, and metastases from extrathoracic malignancies.MethodsA comprehensive and systematic online literature search via Medline/PubMed for the period January 2005 to December 2022 was conducted for articles published using the keywords "EUS-B-FNA", "endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA)", "endoscopic ultrasound fine-needle aspiration (EUS-FNA)", "lung cancer", "staging", and "sarcoidosis".Key content and findingsRecent data prove the efficacy and safety of EUS-B-FNA for providing complete lung cancer staging, when combined with EBUS-TBNA, and in the evaluation of para-esophageal lesions. EUS-B-FNA allows access to inferior mediastinal lymph nodes and para-esophageal masses that are not accessible by EBUS-TBNA. Additional advantages of using EUS-B-FNA include significantly lower doses of anesthetics and sedatives, a shorter procedural time, fewer incidents of oxygen desaturation due to a poor respiratory reserve, significantly less cough, and higher operator satisfaction. Moreover, this procedure can be performed sequentially in the same setting with EBUS-TBNA by one operator. Other benefits include a lower cost, a single setting, and scope use.ConclusionsAs EUS-B-FNA and EBUS-TBNA have complementary access to the mediastinum, the diagnostic yield of EUS-B-FNA combined with EBUS-TBNA is higher than that of endosonographic techniques alone in the diagnostic workup of intrathoracic lesions.
| S-EPMC10586997 | biostudies-literature
Project description:Background The diagnosis of intraparenchymal lung masses is challenging when lesions are located at sites inaccessible through bronchoscopy or endobronchial ultrasound. Endoscopic ultrasound (EUS)-guided tissue acquisition (TA)—fine-needle aspiration (FNA) or fine-needle biopsy—provides a potentially useful diagnostic tool for lesions located adjacent to the esophagus. This study was conducted to analyze the diagnostic outcome and safety of EUS-guided tissue sampling of lung masses. Methods Data were retrieved for patients who underwent transesophageal EUS-guided TA between May 2020 and July 2022 at 2 tertiary care centers. A meta-analysis was performed after pooling these data with studies obtained from a comprehensive search of Medline, Embase, and ScienceDirect from January 2000 to May 2022. Pooled event rates across studies were expressed with summative statistics. Results After screening, 19 studies were identified and, after their data had been combined with those of 14 patients from our centers, a total of 640 patients were included in the analysis. The pooled rate of sample adequacy was 95.4% (95% confidence interval [CI] 93.1-97.8), while the pooled rate of diagnostic accuracy was 93.4% (95%CI 90.7-96.1). The pooled rate of adverse events with transesophageal EUS-guided TA from lung masses was 0.7% (95%CI 0.0-1.6%). There was no significant heterogeneity with respect to various outcomes and results were comparable on sensitivity analysis. Conclusions EUS-FNA offers a safe and accurate diagnostic modality for the diagnosis of paraesophageal lung masses. Future studies are needed to determine the needle type and techniques for improving outcomes.
| S-EPMC9932857 | biostudies-literature
Project description: Not available
| S-EPMC4253030 | biostudies-literature
Project description: Not available
| S-EPMC6058252 | biostudies-literature