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Frank Weilert, Kenneth F Binmoeller
PURPOSE OF REVIEW: Cyanoacrylate (CYA) therapy has become an important component of the therapeutic toolbox of the interventional endoscopists with direct endoscopic injection accepted as first-line therapy of gastric varices. However, its generalized use has been cautioned by its serious adverse event profile. RECENT FINDINGS: Endoscopic ultrasound guided therapy has several conceptual advantages over free-hand injection, particularly as it ensures intravascular delivery of therapy...
July 1, 2016: Current Opinion in Gastroenterology
Frank Weilert, Kenneth F Binmoeller
Endoscopic interventions are first-line therapy for upper and lower gastrointestinal bleeding. Injection therapy in combination with a second endoscopic modality has reduced re-bleeding, need for surgery and mortality in non-variceal bleeding. For variceal bleeding endoscopic banding or cyanoacrylate injection techniques are recommended interventions. However, despite ease of application and general acceptance of these techniques, there is an ongoing re-bleeding rate associated with significant in-hospital mortality...
September 2016: Clinical Gastroenterology and Hepatology
Janak N Shah, Yasser M Bhat, Chris M Hamerski, Steve D Kane, Kenneth F Binmoeller
BACKGROUND AND AIMS: ERCP inherently involves radiation exposure. Nonradiation ERCP has been described in pregnancy. Theoretically, the same techniques could be applied to the general population. We prospectively assessed the feasibility of nonradiation, EUS-based ERCP in nonpregnant patients with choledocholithiasis. METHODS: Consecutive patients referred for ERCP for choledocholithiasis were recruited over a 1-year period. Patients providing study consent underwent the following procedural protocol...
March 31, 2016: Gastrointestinal Endoscopy
Amy Tyberg, Manuel Perez-Miranda, Ramon Sanchez-Ocaña, Irene Peñas, Carlos de la Serna, Janak Shah, Kenneth Binmoeller, Monica Gaidhane, Ian Grimm, Todd Baron, Michel Kahaleh
BACKGROUND: Surgical gastrojejunostomy and enteral self-expanding metal stents are efficacious for the management of gastric outlet obstruction but limited by high complication rates and short-term efficacy. Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is a novel alternative option. PATIENTS AND METHODS: Patients who underwent EUS-GJ between March 2014 and September 2015 as part of a prospective multicenter registry at four academic centers in two countries were included...
March 2016: Endoscopy International Open
Anthony Yuen Teoh, Enders Kwok Ng, Shannon Melissa Chan, Mona Lai, Stuart Moran, Kenneth Frank Binmoeller, Jong Ho Moon, Khek Yu Ho
BACKGROUND AND AIMS: Several EUS-specific stents have become available. It has been claimed that some of these stents have lumen-apposing properties, but objective data measuring such properties are not available. The aim of this study is to measure the lumen-apposing force (LAF) of these stents. METHODS: The LAF of 3 EUS-specific metallic stents (stents A, N, and S) were compared in an ex vivo setting. Four types of anastomoses were performed with the stents including cholecysto-duodenal, cholecysto-gastric, gastro-gastric, and gastro-jejunal and compared with a hand-sewn (HS) equivalent of the anastomosis...
July 2016: Gastrointestinal Endoscopy
Yasser M Bhat, Frank Weilert, R Todd Fredrick, Steven D Kane, Janak N Shah, Chris M Hamerski, Kenneth F Binmoeller
BACKGROUND AND AIMS: Conventional endoscopic treatment of gastric fundal varices (GFV) with cyanoacrylate (CYA) glue may be complicated by embolization and rebleeding. We evaluated the long-term outcomes of EUS-guided injection of coils and CYA glue for therapy of GFV. METHODS: A retrospective chart review of patients treated for GFV was performed. The main outcomes measured were hemostasis, obliteration on surveillance EUS, post-treatment bleeding rate, and adverse events...
June 2016: Gastrointestinal Endoscopy
Frank Weilert, Kenneth F Binmoeller
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary approach to drain an obstructed pancreatic or biliary duct. Failed biliary drainage is traditionally referred for percutaneous transhepatic biliary drainage or surgical bypass, which carry significantly higher morbidity and mortality rates compared with ERCP and transpapillary drainage. Endoscopic ultrasound provides a real-time imaging platform to access and deliver therapy to organs and tissues outside of the bowel lumen. The bile and pancreatic ducts can be directly accessed from the stomach and duodenum, offering an alternative to ERCP when this fails or is not feasible...
October 2015: Gastrointestinal Endoscopy Clinics of North America
Kenneth F Binmoeller, Chris M Hamerski, Janak N Shah, Yasser M Bhat, Steven D Kane
BACKGROUND AND AIMS: EMR of adenomas involving the appendiceal orifice (AO) is controversial because of a high risk of perforation and incomplete resection. We evaluated the feasibility, safety, and outcomes of underwater EMR (UEMR) without submucosal injection for the treatment of adenomas involving the AO. METHODS: This was a prospective, observational study of a standardized UEMR technique without submucosal injection for adenomas involving the AO in 27 consecutive patients meeting inclusion and exclusion criteria...
March 2016: Gastrointestinal Endoscopy
Kenneth F Binmoeller, Yasser M Bhat
No abstract text is available yet for this article.
February 2016: Gastrointestinal Endoscopy
Takao Itoi, Kentaro Ishii, Nobuhito Ikeuchi, Atsushi Sofuni, Takuji Gotoda, Fuminori Moriyasu, Vinay Dhir, Anthony Yuen Bin Teoh, Kenneth F Binmoeller
No abstract text is available yet for this article.
February 2016: Gut
Anthony Yuen Bun Teoh, Lawrence Khek Yu Ho, Vinay Kumar Dhir, Zhen Dong Jin, Mitsuhiro Kida, Dong Wan Seo, Hsui Po Wang, Ai Ming Yang, Kenneth Frank Binmoeller, Shyam Varadarajulu
BACKGROUND: There is a lack of consensus on how endoscopic ultrasound (EUS) guided pseudocyst drainage should be performed. This survey was carried out amongst members of the Asian Endoscopic Ultrasonography Group (AEG) to describe their practices in performing this procedure. METHODS: This was an Asia wide multi-institutional survey amongst members of the Asian EUS group conducted between November and December 2013. The responses to a 19-question survey with regard to the practice of pseudocyst drainage were obtained...
April 2015: Endoscopy International Open
Mouen A Khashab, Todd H Baron, Kenneth F Binmoeller, Takao Itoi
No abstract text is available yet for this article.
May 2015: Gastrointestinal Endoscopy
Kenneth F Binmoeller, Christopher M Hamerski, Janak N Shah, Yasser M Bhat, Steven D Kane, Richard Garcia-Kennedy
OBJECTIVE: To evaluate the feasibility and outcomes of attempted underwater en bloc resection (UEBR) of large colorectal laterally spreading tumors (LSTs). DESIGN: Prospective, observational study. SETTING: Tertiary academic referral center. PATIENTS: Fifty patients meeting the inclusion and exclusion criteria. INTERVENTIONS: Standardized UEBR technique involving attempted en bloc resection without submucosal injection by using a large 33-mm snare...
March 2015: Gastrointestinal Endoscopy
Marc Barthet, Kenneth F Binmoeller, Geoffroy Vanbiervliet, Jean-Michel Gonzalez, Todd H Baron, Stéphane Berdah
BACKGROUND: We established feasibility and safety for natural orifice transluminal endoscopic surgery (NOTES) GI anastomosis with a lumen-apposing stent in live pigs. This approach was performed in 3 patients. OBJECTIVE: Creation of a NOTES gastroduodenal anastomosis in patients. DESIGN: Case series. SETTING: Two tertiary-care referral centers at large academic hospitals in France and in the United States. PATIENTS: Patients with refractory benign duodenal stenosis and malignant duodenal obstruction...
January 2015: Gastrointestinal Endoscopy
Frank Weilert, Kenneth F Binmoeller
Expert knowledge of endoscopic management of gastric varices is essential, as these occur in 20% of patients with portal hypertension. Bleeding is relatively uncommon, but carries significant mortality when this occurs. Inability to directly target intravascular injections and the potential complication related to glue embolization has resulted in the development of novel techniques. Direct visualization of the varix lumen using endoscopic ultrasound (EUS) allows targeted therapy of feeder vessels with real-time imaging...
December 2014: Gastroenterology Clinics of North America
Kenneth F Binmoeller, Oriol Sendino, Steven D Kane
The gastrointestinal tract provides a unique "window" to access vascular structures in the mediastinum and abdomen. The advent of interventional endoscopic ultrasound (EUS) has enabled access to these structures with a standard fine-needle aspiration (FNA) needle. Sclerosants, cyanoacrylate, and coils can be delivered through the lumen of the FNA needle. EUS-guided treatment of gastric varices has theoretical advantages over conventional endoscopy-guided treatment. Controlled studies are needed to determine the role of EUS-guided treatment for primary and secondary prevention of variceal bleeding...
January 2015: Journal of Hepato-biliary-pancreatic Sciences
Yasser M Bhat, Steve D Kane, Janak N Shah, Chris M Hamerski, Kenneth F Binmoeller
No abstract text is available yet for this article.
August 2014: Gastrointestinal Endoscopy
Kenneth F Binmoeller, Ioana Smith, Monica Gaidhane, Michel Kahaleh
OBJECTIVE: Transluminal pseudocyst drainage with currently available tools remains technically challenging, time consuming and limited to fluid collections adherent to the GI tract. Multiple tools and steps are still required to achieve pseudocyst drainage. We evaluated a novel kit to facilitate endoscopic ultrasonography (EUS)-guided access, drainage and rapid decompression in a porcine model. METHODS: The kit consists of the NAVIX access device and the AXIOS stent delivery system...
October 2012: Endoscopic Ultrasound
Anthony Yuen Bun Teoh, Kenneth Frank Binmoeller, James Yun Wong Lau
No abstract text is available yet for this article.
December 2014: Gastrointestinal Endoscopy
Frank Weilert, Yasser M Bhat, Kenneth F Binmoeller, Steve Kane, Ian M Jaffee, Richard E Shaw, Rees Cameron, Yusuke Hashimoto, Janak N Shah
BACKGROUND: Both EUS and ERCP sampling techniques may provide tissue diagnoses in suspected malignant biliary obstruction. However, there are scant data comparing these 2 methods. OBJECTIVE: To compare EUS-guided FNA (EUS-FNA) and ERCP tissue sampling for the diagnosis of malignant biliary obstruction. DESIGN: Prospective, comparative, single-blind study. SETTING: Tertiary center. PATIENTS: Fifty-one patients undergoing same-session EUS and ERCP for the evaluation of malignant biliary obstruction over a 1-year period...
July 2014: Gastrointestinal Endoscopy
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