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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(11): E1717-E1724
DOI: 10.1055/a-1264-7206
Original article

Feasibility and safety study of 22-gauge endoscopic ultrasound (EUS) needles for portal vein sampling in a swine model

Kenneth Park
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Daniel Lew
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Christopher Chapman
2   University of Chicago Medical Center, Center for Endoscopic Research and Therapeutics, Chicago, Illinois, United States
,
Ashley Wachsman
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Matthew Bloom
3   Cedars-Sinai Medical Center – Surgery, Los Angeles, California, United States
,
Liiana Bancila
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Rachel Perry
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Qiang Wang
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Laith Jamil
4   William Beaumont Hospital – Royal Oak, Gastroenterology and Hepatology, Royal Oak, Michigan, United States
,
Stephen Pandol
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
,
Simon Lo
1   Cedars-Sinai Medical Center, Division of Digestive Diseases, Los Angeles, California
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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.



Publication History

Received: 29 May 2020

Accepted: 20 August 2020

Article published online:
22 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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