Dataset Information

EUS Needle Identification Comparison and Evaluation study (with videos).

ABSTRACT: EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development.Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices.There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001).All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity.

SUBMITTER: Tang SJ

PROVIDER: S-EPMC5570521 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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EUS Needle Identification Comparison and Evaluation study (with videos).

Tang Shou-Jiang SJ Vilmann Andreas S AS Saftoiu Adrian A Wang Wanmei W Streba Costin Teodor CT Fink Peter P PP Griswold Michael M Wu Ruonan R Dietrich Christoph F CF Jenssen Christian C Hocke Michael M Kantowski Marcus M Pohl Jürgen J Fockens Paul P Annema Jouke T JT van der Heijden Erik H F M EH Havre Roald Flesland RF Pham Khanh Do-Cong KD Kunda Rastislav R Deprez Pierre H PH Mariana Jinga J Vazquez-Sequeiros Enrique E Larghi Alberto A Buscarini Elisabetta E Fusaroli Pietro P Lahav Maor M Puri Rajesh R Garg Pramod Kumar PK Sharma Malay M Maluf-Filho Fauze F Sahai Anand A Brugge William R WR Lee Linda S LS Aslanian Harry R HR Wang Andrew Y AY Shami Vanessa M VM Markowitz Arnold A Siddiqui Ali A AA Mishra Girish G Scheiman James M JM Isenberg Gerard G Siddiqui Uzma D UD Shah Raj J RJ Buxbaum James J Watson Rabindra R RR Willingham Field F FF Bhutani Manoop S MS Levy Michael J MJ Harris Cynthia C Wallace Michael B MB Nolsøe Christian Pállson CP Lorentzen Torben T Bang Niels N Sørensen Sten Mellerup SM Gilja Odd Helge OH D'Onofrio Mirko M Piscaglia Fabio F Gritzmann Norbert N Radzina Maija M Sparchez Zeno Adrian ZA Sidhu Paul S PS Freeman Simon S McCowan Timothy C TC de Araujo Cyrillo Rodrigues CR Patel Akash A Ali Mohammad Adel MA Campbell Garth G Chen Edward E Vilmann Peter P

Gastrointestinal endoscopy 20160210 3

<h4>Background and aims</h4>EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development.<h4>Methods</h4>Descri ...[more]

PMID: 26873530

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Project description:Background and aimsEUS-guided gastroenterostomy (EUS-GE) is effective in relieving gastric outlet obstruction. Several techniques used to create EUS-GEs have been described. However, these techniques are dependent on passing a guidewire beyond the obstruction. We describe a direct needle-puncture technique that allows for successful EUS-GE creation without a guidewire.MethodsThe direct antegrade EUS-GE method often involves passing a guidewire and tube beyond the obstruction to distend the small bowel. An oblique echoendoscope is then positioned in the stomach to locate the distended small bowel. An electrocautery-enhanced lumen-apposing metal stent (LAMS) is used to create the anastomosis. However, in cases when neither endoscope nor guidewire can be passed across the obstruction, the direct needle-puncture technique can be used. With the oblique echoendoscope positioned in the stomach, a collapsed loop of small bowel is located adjacent to the gastric wall. A 19-gauge needle is used to puncture the gastric and small bowel wall. The small bowel is distended with a mixture of saline, methylene blue, and contrast via a standard water pump connected to the needle. An antispasmodic is administered, and an electrocautery-enhanced LAMS is then introduced into the working channel to create a gastroenterostomy using the freehand method.ResultsThe direct needle-puncture technique was performed in 4 patients for these indications: postsurgical inflammation causing gastric outlet obstruction (case 1), tumor infiltration causing gastric outlet obstruction (cases 2A and 2B), and pancreaticobiliary limb access in a duodenal switch (case 3). The video shows the technique performed in a patient with postsurgical inflammation and a patient with duodenal tumor infiltration.ConclusionsThe direct needle-puncture technique is useful for performing gastroenterostomy when the guidewire cannot be passed beyond the obstruction. It can also be used to gain access to a targeted bowel limb in altered anatomy for diagnostic and therapeutic purposes.

Dataset Information

EUS Needle Identification Comparison and Evaluation study (with videos).

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EUS Needle Identification Comparison and Evaluation study (with videos).

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