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Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Portal Vein Thrombus in the Diagnosis and Staging of Hepatocellular Carcinoma
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Dina Eskandere, Hazem Hakim, Magdy Attwa, Wagdi Elkashef, Ahmed Youssef Altonbary
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Clin Endosc 2021;54(5):745-753. Published online March 15, 2021
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DOI: https://doi.org/10.5946/ce.2020.240
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 Abstract
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- Background
/Aims: Malignant portal vein thrombus (PVT) is found in up to 44% of patients with hepatocellular carcinoma (HCC). The nature of the thrombus influences treatment selection. The aim of this study was to assess the safety and efficacy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in determining the nature of PVT in liver cirrhosis and/or HCC.
Methods
A prospective study was conducted in 34 patients with liver cirrhosis and/or HCC with PVT. Under EUS guidance, PVT was punctured using a 22 G FNA needle (Cook Medical, Bloomington, IN, USA) followed by monitoring of the puncture tract using color Doppler. Patients were followed for adverse events 2 hours after recovery.
Results
Throughout the 30-month study period, 34 patients, including 24 males with a mean age of 59±8 years, were enrolled. There were 8 patients with known HCC and 26 with no liver masses detected by computed tomography (CT). EUS-FNA from PVT was positive for malignancy in 3 patients (8.8%), of which only 1 patient was diagnosed with HCC by CT and 2 patients were newly diagnosed with HCC after EUS-FNA. No major complications were reported.
Conclusions
EUS-FNA is a safe and effective technique for determining the nature of PVT that does not fulfill the malignant criteria via imaging studies in patients with liver cirrhosis and/or HCC.
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Citations
Citations to this article as recorded by  - Endoscopic ultrasound–guided vascular interventions: A review (with videos)
Praveer Rai, Pankaj Kumar, Umair Shamsul Hoda, Kartik Balankhe
Indian Journal of Gastroenterology.2024; 43(5): 927. CrossRef - Endoscopic ultrasound-guided vascular interventions: An overview of current and emerging techniques
Ahmed Youssef Altonbary
International Journal of Gastrointestinal Intervention.2023; 12(1): 16. CrossRef - Endoscopic ultrasound in portal hypertension: navigating venous hemodynamics and treatment efficacy
Irina Dragomir, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Bogdan Procopet, Andrada Seicean
Gastroenterology Report.2023;[Epub] CrossRef
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