EUS-guided vascular therapy: an effective approach for refractory and per-endoscopic non-variceal gastrointestinal bleeding
Abstract
Background:: Endoscopic ultrasound (EUS) offers transparietal access to vascular structures, enabling localized treatment. Few studies have been published about EUS-guided vascular therapy, with a limited number of patients, especially in non-variceal bleeding. We present our results in this setting.
Objectives:: The primary objective was to evaluate the efficacy of EUS-guided vascular embolization, defined as the disappearance of both Doppler signal and bleeding. Secondary objectives were to document adverse events (AGREE classification), the rate of recurrences, and their management.
Design:: This was a single-center retrospective observational study.
Methods:: All patients included underwent EUS-guided vascular embolization for spontaneous or intraoperative non-variceal GI bleeding, using acrylic bioglue with Lipiodol as embolizing agent.
Results:: A total of 42 patients, aged between 31 and 88 years, were included (median 67.5). The origin of the bleeding was spontaneous on a pre-existing lesion in 59.5% of cases, and consecutive to an endoscopic procedure in 40.5% of cases. Initial technical and clinical success rates were 100%. No major adverse event was observed. Seven patients (16.7%) experienced a bleeding recurrence, with a median delay of 42 days [2–127], all in the spontaneous group. Five were managed by a second EUS-guided embolization, and one had a third recurrence managed surgically.
Conclusion:: This study underlines the major value of EUS-guided vascular approach in the treatment of recurrent and complex, as well as intraoperative GI bleedings, showing a high efficacy rate and good safety profile. Improvements in embolization techniques and devices would further democratize the procedure.
Related
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- Day of Arrival as a Determinant of Endoscopy Timing in Non-Variceal Upper Gastrointestinal Bleeding: A Natural-Experiment Cohort Study of Clinical Outcomes and Length of Stay
- Increasing Adoption Trends of Gastric Per-Oral Endoscopic Myotomy Over Gastric Electrical Stimulation for Refractory Gastroparesis: A Nationwide Analysis.
BibTeX
@article{irigoyen2026eusguided,
title = {{EUS-guided vascular therapy: an effective approach for refractory and per-endoscopic non-variceal gastrointestinal bleeding}},
author = {Alexis Irigoyen and Mohamed Gasmi and Marc Barthet and Jean-Michel Gonzalez},
journal = {Therapeutic Advances in Gastrointestinal Endoscopy},
year = {2026},
month = sep,
doi = {10.1177/26317745251405741},
url = {https://doi.org/10.1177/26317745251405741},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - EUS-guided vascular therapy: an effective approach for refractory and per-endoscopic non-variceal gastrointestinal bleeding
AU - Alexis Irigoyen
AU - Mohamed Gasmi
AU - Marc Barthet
AU - Jean-Michel Gonzalez
PY - 2026
DA - 2026/09/17
JO - Therapeutic Advances in Gastrointestinal Endoscopy
DO - 10.1177/26317745251405741
UR - https://doi.org/10.1177/26317745251405741
AB - Background:: Endoscopic ultrasound (EUS) offers transparietal access to vascular structures, enabling localized treatment. Few studies have been published about EUS-guided vascular therapy, with a limited number of patients, especially in non-variceal bleeding. We present our results in this setting. Objectives:: The primary objective was to evaluate the efficacy of EUS-guided vascular embolization, defined as the disappearance of both Doppler signal and bleeding. Secondary objectives were to document adverse events (AGREE classification), the rate of recurrences, and their management. Design:: This was a single-center retrospective observational study. Methods:: All patients included underwent EUS-guided vascular embolization for spontaneous or intraoperative non-variceal GI bleeding, using acrylic bioglue with Lipiodol as embolizing agent. Results:: A total of 42 patients, aged between 31 and 88 years, were included (median 67.5). The origin of the bleeding was spontaneous on a pre-existing lesion in 59.5% of cases, and consecutive to an endoscopic procedure in 40.5% of cases. Initial technical and clinical success rates were 100%. No major adverse event was observed. Seven patients (16.7%) experienced a bleeding recurrence, with a median delay of 42 days [2–127], all in the spontaneous group. Five were managed by a second EUS-guided embolization, and one had a third recurrence managed surgically. Conclusion:: This study underlines the major value of EUS-guided vascular approach in the treatment of recurrent and complex, as well as intraoperative GI bleedings, showing a high efficacy rate and good safety profile. Improvements in embolization techniques and devices would further democratize the procedure.
SN - 2631-7745
ER -