EUS targeting of vascular thrombosis: Risky business?

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Presentation transcript:

EUS targeting of vascular thrombosis: Risky business? Adrian Săftoiu, MD, PhD, MSc, FASGE Gastrointestinal Endoscopy Volume 86, Issue 1, Pages 156-160 (July 2017) DOI: 10.1016/j.gie.2016.11.028 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Contrast-enhanced harmonic EUS view in the early arterial phase showing a bland (avascular) superior mesenteric vein (SMV) thrombus suggesting a benign lesion. A section of the SMV is shown in the blue box posterior to the pancreas, with hyperenhanced walls and nonenhanced avascular thrombus in the middle. B, EUS elastographic view showing a relatively soft appearance of the thrombus in the middle of the superior mesenteric vein, also in favor of a benign diagnosis. The SMV thrombus is shown in the middle of the yellow box. Gastrointestinal Endoscopy 2017 86, 156-160DOI: (10.1016/j.gie.2016.11.028) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 A, Contrast-enhanced harmonic EUS view in the early arterial phase showing a portal vein (PV) thrombus taking up contrast medium, followed by washout in the portal phase, suggesting malignancy. A section of the liver hilum is shown in the blue box, with the hyperenhanced hepatic artery, enhanced PV thrombus, and nonenhanced common bile duct. B, EUS elastographic view showing a relatively hard appearance of the enlarged thrombus (20 mm) in the portal vein (PV), in favor of malignancy, in a young patient with a large retroperitoneal tumor mass. The PV thrombus is shown in the left lower corner of the yellow box. Gastrointestinal Endoscopy 2017 86, 156-160DOI: (10.1016/j.gie.2016.11.028) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions