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Park K, Lew D, Chapman C, Wachsman A, Bloom M, Bancila L, Perry R, Wang Q, Jamil L, Pandol S, Lo S. Feasibility and safety study of 22-gauge endoscopic ultrasound (EUS) needles for portal vein sampling in a swine model. Endosc Int Open 2020; 8:E1717-E1724. [PMID: 33140030 PMCID: PMC7581479 DOI: 10.1055/a-1264-7206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/20/2020] [Indexed: 11/09/2022] Open
Abstract
Background and study aims Endoscopic ultrasound (EUS) has been used for portal vein sampling in patients with pancreaticobiliary cancers for enumerating circulating tumor cells but is not yet a standard procedure. Further evaluation is needed to refine the methodology. Therefore, we evaluated the feasibility and safety of 19-gauge (19G) versus a 22-gauge (22 G) EUS fine-needle aspiration needles for portal vein sampling in a swine model. Methods Celiotomy was performed on two farm pigs. Portal vein sampling occurred transhepatically. We compared 19 G and 22 G needles coated interiorly with saline, heparin or ethylenediaminetetraacetic acid (EDTA). Small- (10 mL) and large- (25 mL) volume blood collections were evaluated. Two different collection methods were tested: direct-to-vial and suction syringe. A bleeding risk trial for saline-coated 19 G and 22 G needles was performed by puncturing the portal vein 20 times. Persistent bleeding after 3 minutes was considered significant. Results All small-volume collection trials were successful except for 22 G saline-coated needles with direct-to-vial method. All large-volume collection trials were successful when using suction syringe; direct-to-vial method for both 19 G and 22 G needles were unsuccessful. Collection times were shorter for 19 G vs. 22 G needles for both small and large-volume collections ( P < 0.05). Collection times for saline-coated 22 G needles were longer compared to heparin/EDTA-coated ( P < 0.05). Bleeding occurred in 10 % punctures with 19 G needles compared to 0 % with 22 G needles. Conclusion The results of this animal study demonstrate the feasibility and the safety of using 22 G needles for portal vein sampling and can form the basis for a pilot study in patients.
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Affiliation(s)
- Kenneth Park
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Daniel Lew
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Christopher Chapman
- University of Chicago Medical Center, Center for Endoscopic Research and Therapeutics, Chicago, Illinois, United States
| | - Ashley Wachsman
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Matthew Bloom
- Cedars-Sinai Medical Center – Surgery, Los Angeles, California, United States
| | - Liiana Bancila
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Rachel Perry
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Qiang Wang
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Laith Jamil
- William Beaumont Hospital – Royal Oak, Gastroenterology and Hepatology, Royal Oak, Michigan, United States
| | - Stephen Pandol
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
| | - Simon Lo
- Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
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