Endoscopic ultrasound guided coil treatment at gastric varices скачать в хорошем качестве

Endoscopic ultrasound guided coil treatment at gastric varices

We will talk about the fundic varices closure with endoscopic systems. There are two theropeutic method. 1-Cynoacrylate Glue….Before we use it without endoscopic ultrasound..now we use it with endoscopic ultrasound. To use endoskopic US is more useful . 2-Coil Gastric varices involves the placement of micro-coils into the varices leading to obliteration.There is minimum complication and the result is effective. Here I will show you one of the patient..We use nester tip coils,soft platinum pack tightly into 1-2 centimetre occluding mass, synthetic fibres boost clot formation for speedy embolisation. And there is another alternative tornado type coils but they are more expensive. As you see here there is gastric varices..this patient is diagnosed.At the left part you can see the varices.We used endoscopic ultrasonography. We should find the perforating vein.. we enter into this vein with endoscopic needle and push the stylet out. Most coils can be advanced through this needle.With this coil varice is thrombosised. At the second coil placement the lumen is slowly closed. we decided a third coil placement and we are doing that.We continue with the needle to the target varice ,but we should be careful about the bleeding.and lastly we make doppler. Here you see the coils with the fluoroscopic image. At the end, the perforating vein is totaly occluded with coils. And gastric varices disappeared.