Endoscopy 2021; 53(09): E343-E344
DOI: 10.1055/a-1290-7001
E-Videos

Balloon-assisted endoscopic sclerotherapy: a novel technology

Xuecan Mei*
1  Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
,
Xi Wang*
1  Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
,
Wenyue Wu
1  Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
,
Yi Xiang
1  Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
,
Yi Han
2  Department of Gastroenterology, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, China
,
Derun Kong
1  Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
2  Department of Gastroenterology, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, China
› Author Affiliations
 

Endoscopic injection sclerotherapy is an effective method for treating esophageal variceal hemorrhage [1] [2]. However, owing to the rapid loss of the sclerosing agent, the overall effect of sclerotherapy is weakened. Therefore, increasing the residence time of the sclerosing agent remains a focal point of current investigations. The present study reported a case treated with a novel technology termed balloon-assisted endoscopic sclerotherapy.

A 48-year-old man was admitted to our department following a diagnosis of esophageal varices. An endoscopy revealed the presence of four varices in the esophagus, with a maximum diameter of 1.0 cm ([Fig. 1]). Therefore, endoscopic balloon-assisted sclerotherapy was immediately performed. The balloon was inserted on the front end of the gastroscope and fixed at a distance of 3 to 5 cm from the tip ([Fig. 2]). The inner diameter of the balloon was 1.1 cm, and the outer diameter before and after inflation was 1.3 cm and 1.8 cm, respectively. The endoscope was then used to enter the vicinity of the treated blood vessel, and the balloon was opened up and inflated with 2 ml of air ([Fig. 3]). Following this procedure, the selected blood vessel was subsequently treated with sclerotherapy. Briefly, the sclerosing agent (10 ml polycinnamyl alcohol + 0.1 ml meilan) was injected into the blood vessel and the balloon was used to continuously compress the blood vessel for 10 minutes ([Video 1]). The tee was closed after the air in the balloon was completely deflated. On follow-up 1 month later, the patient’s varicose veins were significantly atrophied ([Fig. 4]), and endoscopic ultrasonography showed no obvious blood flow signal under the varicose vein ([Fig. 5]).

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Fig. 1 Endoscopy revealed the presence of four varices in the esophagus, with a maximum diameter of 1.0 cm.
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Fig. 2 Components of the device include the balloon, catheter, and tee. The balloon was inserted from the front end of the gastroscope and fixed at a distance of 3 to 5 cm from the tip.
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Fig. 3 The balloon was filled with 2 ml of air.

Video 1 A case treated with a novel technology termed balloon-assisted endoscopic sclerotherapy.


Quality:
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Fig. 4 On follow-up 1 month later, the patient’s varicose veins were significantly atrophied.
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Fig. 5 Endoscopic ultrasonography showed no obvious blood flow signal under the varicose vein.

In conclusion, balloon-assisted sclerotherapy under endoscopy was discovered to improve the therapeutic efficacy of the sclerosing agent. Compared with Tatsuyuki Kawano’s balloon method [3], the present method was also simpler and more practical.

Endoscopy_UCTN_Code_TTT_1AO_2AD

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Competing interests

The authors declare that they have no conflict of interest.

* Joint first authors



Corresponding author

Derun Kong, MD
Department of Gastroenterology
First Affiliated Hospital of Anhui Medical University
218 Jixi Road, Shushan District
Hefei 230022, Anhui Province
China   
Fax: +86-551-63633742   

Publication History

Publication Date:
11 November 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany


Zoom Image
Fig. 1 Endoscopy revealed the presence of four varices in the esophagus, with a maximum diameter of 1.0 cm.
Zoom Image
Fig. 2 Components of the device include the balloon, catheter, and tee. The balloon was inserted from the front end of the gastroscope and fixed at a distance of 3 to 5 cm from the tip.
Zoom Image
Fig. 3 The balloon was filled with 2 ml of air.
Zoom Image
Fig. 4 On follow-up 1 month later, the patient’s varicose veins were significantly atrophied.
Zoom Image
Fig. 5 Endoscopic ultrasonography showed no obvious blood flow signal under the varicose vein.