ASGE Endoscopy Live: Interventional EUS and Endo-Hepatology (On-Demand) | July 2023-7-13-23 Endoscopy Live Case Demonstration 8

7-13-23 Endoscopy Live Case Demonstration 8 - Brigham and Womens

Video Transcription

Video Summary

In this video, Dr. Mervyn Dew from Brigham and Women's Hospital demonstrates an endoscopic ultrasound (EUS) guided coil embolization procedure for gastric varices using an absorbable gelatin sponge. The patient is a woman with decompensated cirrhosis secondary to alcohol use disorder and small esophageal varices. Due to a high risk of complications, an alternative to balloon-assisted retrograde transvenous obliteration (BRTO) was chosen. The procedure involves inserting coils into the varices to stop bleeding and injecting gel foam for further hemostasis. Coils are selected based on the size of the varices, and gel foam is mixed with saline and contrast for injection. The video shows the coils being deployed and the gel foam being injected. The goal is complete resolution of Doppler flow. The procedure is performed under general anesthesia and fluoroscopy is used as an adjunct. Dr. Dew also discusses the benefits of gel foam over traditional cyanacrylate glue.

Asset Subtitle

EUS-guided coil embolization with absorbable gelatin sponge for gastric varices
Endoscopist: Dr. Marvin Ryou (Brigham and Women’s Hospital)

Keywords

endoscopic ultrasound

coil embolization

gastric varices

absorbable gelatin sponge

cirrhosis

alcohol use disorder