Therapeutic Applications of Endoscopic Ultrasound Needles: Expanding Beyond Diagnosis

 

Therapeutic Applications of Endoscopic Ultrasound Needles: Expanding Beyond Diagnosis

While endoscopic ultrasound (EUS) needles have traditionally been employed for diagnostic tissue acquisition, their versatility has led to a rapidly expanding array of therapeutic applications. Leveraging the precise real-time imaging capabilities of EUS, these needles are now being used to deliver various therapeutic agents and perform minimally invasive interventions in areas previously accessible only through more invasive surgical approaches.

One of the well-established therapeutic uses of EUS needles is the drainage of pancreatic fluid collections, such as pseudocysts and walled-off necrosis. Using EUS guidance, a needle is inserted into the collection, followed by the placement of a stent to allow for drainage of the fluid into the gastrointestinal lumen. This minimally invasive approach has become the preferred method for managing many pancreatic fluid collections, offering advantages over surgical drainage in terms of recovery time and morbidity.

EUS needles are also increasingly utilized for EUS-guided biliary drainage in patients with obstructive jaundice where traditional endoscopic retrograde cholangiopancreatography (ERCP) has failed or is not feasible. By directly puncturing the bile duct from the stomach or duodenum under EUS guidance, a guidewire can be advanced, followed by the placement of a stent to relieve the obstruction.

Another significant therapeutic application is EUS-guided tumor ablation. Specialized needles can be used to deliver ablative agents, such as alcohol or radiofrequency energy, directly into tumors located in the pancreas, liver, or other organs. This localized treatment approach can be used for palliation in advanced cancers or as a primary treatment modality for small, localized tumors in patients who are not candidates for surgery.

EUS-guided injection of fiducial markers is another important therapeutic application, particularly in the management of gastrointestinal cancers. These small metallic markers are injected into or near tumors using EUS needles to provide precise targets for radiation therapy, allowing for more accurate and effective delivery of radiation while minimizing damage to surrounding healthy tissues.

Furthermore, EUS needles are being explored for the delivery of therapeutic agents directly into tumors, including chemotherapy drugs, gene therapy vectors, and oncolytic viruses. This targeted drug delivery approach aims to increase the local concentration of the therapeutic agent within the tumor while reducing systemic side effects.

The expanding therapeutic applications of EUS needles highlight the transformative potential of this technology in minimally invasive interventions. Ongoing research and development continue to explore new ways to utilize these versatile tools for the treatment of a wide range of gastrointestinal and related disorders, offering less invasive and potentially more effective options for patients.

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