ASGE DDW Videos from Around the World | 2022-EUS GUIDED EMBOLIZATION OF A REFRACTORY SPLENIC PSEUDOANEURYSM

EUS GUIDED EMBOLIZATION OF A REFRACTORY SPLENIC PSEUDOANEURYSM

Video Transcription

Video Summary

In the video, the speaker discusses a case of a 45-year-old female with alcoholic cirrhosis who presented with recurrent upper GI bleeding. Despite multiple interventions, including embolizations, the patient had a persistent splenic pseudoaneurysm. The decision was made to perform an endoscopic ultrasound (EUS)-guided embolization using thrombin and sionacrolate glue. The procedure involved identifying the pseudoaneurysm using Doppler techniques, injecting contrast to confirm its location, and then injecting thrombin and glue to obliterate the pseudoaneurysm. Following the procedure, the patient no longer required transfusions and had no recurrence of GI bleeding for nine months. EUS-guided embolization is a promising approach for refractory pseudoaneurysms, with the main challenge being accurate identification of the pseudoaneurysm. Careful withdrawal of the needle is important to prevent complications.

Keywords

alcoholic cirrhosis

upper GI bleeding

EUS-guided embolization

pseudoaneurysm

Doppler techniques