Advanced Endoscopy Fellows Program | September 2024-Interventional EUS Troubleshooting

Video Transcription

Video Summary

Dr. Amy Tyberg discussed troubleshooting during interventional endoscopic ultrasound (EUS) procedures, particularly focusing on lumen-opposing metal stents (LAMS), which have become integral in advanced endoscopy. Despite their user-friendly design, adverse events, such as bleeding, migration, occlusion, and maldeployment, can occur. To prevent these issues, practitioners should thoroughly review imaging to identify potential risks like abnormal vasculature and use Doppler ultrasound to avoid vessel compression. Techniques for handling bleeding include gradual balloon dilation and use of hemostatic methods. Migration and occlusion can often be managed by appropriate stent deployment and monitoring, while maldeployments, akin to perforations, require a calm, methodical approach to stabilize the patient and determine the maldeployment type to guide the management. Dr. Tyberg emphasized the importance of publishing adverse events to share learning experiences and showed videos demonstrating how problematic deployments can be managed using techniques like the stent-in-stent method and notes procedures.

Asset Subtitle

Dr. Amy Tyburg

Keywords

interventional endoscopic ultrasound

lumen-opposing metal stents

adverse events

Doppler ultrasound

stent deployment

bleeding management