The human vascular system represents a unique highway that allows access to every part of the body, and problems with the system can result in serious health conditions. The ability to safely intervene, diagnose, and treat vascular abnormalities with minimally-invasive techniques represents significant advances in the practice of medicine.

In this study, researchers review the technical challenges and potential value of an endoscopic ultrasound (EUS)-guided angiography. Endoscopic ultrasonography is the practice of using an ultrasound transducer at the tip of an endoscope to visualize and offer therapeutic intervention to the gastrointestinal tract and its surrounding structures, which includes nearby vasculature and organs.

The researchers tested the feasibility of EUS to perform angiography in three pigs. EUS was conducted on each pig to identify major blood vessels, including the thoracic and abdominal aorta, celiac axis, superior mesenteric artery, splenic vein, portal vein, splenic artery and hepatic veins. During the EUS, the researchers injected contrast to improve vascular visualization, and - performed angiography using several different gauge aspirate needles (19g, 22g and 25g). Pigs were then euthanized to examine the results.

The process demonstrated excellent visualization of the vasculature, and without any technical difficulties in injecting each artery. The 25g needle did not cause any visible vascular damage, though the 22g needle caused a puncture and the 19g needle caused limited bleeding. The contrast injection was easiest with the 19g needle and most difficult with the 25g needle. In each case, however, EUS-guided angiography successfully and clearly highlighted the vessels.

"We feel that based on the results of this study as well as the close proximity of the intestinal wall to vasculature, an EUS-guided approach to perform selective angiography is feasible. Safe access to the vasculature is just the first step to performing EUS-guided therapeutic intervention throughout the vasculature," said Sanjay Jagannath, M.D., of Johns Hopkins Hospital and co-author of the study. "We plan further research in the near future so that this technique may one day be more widely used in the human arena."

[Abstract W1321]

Digestive Disease Week� (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 20-25, 2006 in Los Angeles, California. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.

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