Year 2025 / Volume 117 / Number 10
Letter
Uneventful salvage for partial deployment of a coil via endoscopic ultrasound in the treatment of rebleeding gastric varices

598-599

DOI: 10.17235/reed.2024.10647/2024

Yu Tang, Huiwei Zhang, Lijuan Ren, Min Xie, Ke Liu, Lizhi Yi, Xiaoling Zhou, Xianfei Zhong,

Abstract
A 72-year-old female who had received emergent endoscopic cyanoacrylate (CYA) injection for bleeding gastric varices (GV) two month before was readmitted due to recurrence of melena. Current gastroscopy verified the type-2 GV (GOV-2) according to Sarin’s classification with stigmata of recent bleeding. Endoscopic ultrasound (EUS) identified the largest varix of 8.7mm in diameter, which prompted us to consider EUS-guided coiling combined with CYA injection as an alternative therapeutic strategy, considering the short interval between prior injection and rebleeding. Via trans-esophageal route, the abovementioned varix was punctured using a 19-gauge FNA needle preloaded with a 0.035-inch coil with diameter of 10mm and length of 14cm (Nester, Cook Medical, Bloomington, IN). Initially, the stylet used as a pusher was advanced smoothly and part of the coil was visualized to have been pushed out of the needle tip. However, the stylet could not be fully advanced to place the entire coil into the varix due to substantial resistance, which, regardless of the endeavor to adjust the needle, was not diminished.
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References
Patel K. Top tips for EUS-guided embolization of gastric varices (with videos). Gastrointest Endosc. 2024 Feb;99(2):254-256. doi: 10.1016/j.gie.2023.09.007. Epub 2023 Oct 5. PMID: 37802424.
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Tang Y, Zhang H, Ren L, Xie M, Liu K, Yi L, et all. Uneventful salvage for partial deployment of a coil via endoscopic ultrasound in the treatment of rebleeding gastric varices. 10647/2024


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Publication history

Received: 11/07/2024

Accepted: 18/07/2024

Online First: 01/08/2024

Published: 10/10/2025

Article Online First time: 21 days

Article editing time: 456 days


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