Double Guidewire Technique Using an Uneven Double Lumen Catheter for Endoscopic Ultrasound-Guided Interventions

Background Endoscopic ultrasonography (EUS)-guided interventions are often performed using a single guidewire (SGW), but there are a few reports on the use of double guidewire (DGW) technique to facilitate multiple drainage placement during EUS-guided drainage of pancreatic fluid collections. This D...

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Bibliographic Details
Published in:Digestive diseases and sciences 2021-05, Vol.66 (5), p.1540-1547
Main Authors: Nakai, Yousuke, Oyama, Hiroki, Kanai, Sachiko, Noguchi, Kensaku, Sato, Tatsuya, Hakuta, Ryunosuke, Ishigaki, Kazunaga, Saito, Kei, Saito, Tomotaka, Hamada, Tsuyoshi, Takahara, Naminatsu, Mizuno, Suguru, Kogure, Hirofumi, Isayama, Hiroyuki, Koike, Kazuhiko
Format: Article
Language:English
Subjects:
Analysis
Biochemistry
Catheters
Endoscopy
Fistula
Gastroenterology
Hepatology
Hospitals
Medicine
Medicine & Public Health
Oncology
Original Article
Success
Transplant Surgery
Ultrasonic imaging
Ultrasound imaging
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Summary:Background Endoscopic ultrasonography (EUS)-guided interventions are often performed using a single guidewire (SGW), but there are a few reports on the use of double guidewire (DGW) technique to facilitate multiple drainage placement during EUS-guided drainage of pancreatic fluid collections. This DGW technique may have advantages other than multiple drainage placement during EUS-guided interventions such as scope stabilization, support for stone extraction and device insertion. Methods Consecutive patients who underwent EUS-guided interventions between Feb 2012 and Apr 2019 were retrospectively reviewed. The rate and reasons of DGW technique, and clinical outcomes were evaluated. DGW technique was performed, using an uneven double lumen cannula (UDLC), which facilitates insertion of 0.025-in. and 0.035-in. guidewires. Results A total of 249 EUS-guided interventions were analyzed, and DGW technique was utilized primarily in 65 cases (25.7%) and as a salvage after failed SGW technique in 18 cases (7.1%). The reasons for DGW technique were 60 multiple drainage placement, 10 scope stabilization, 7 device insertion, 5 safety guidewire, and 4 antegrade stone removal. Insertion of UDLC and DGW was successful in 100%. Technical success rate of preplanned interventions was 92.7% (96.9% in primary DGW and 77.8% in salvage DGW technique). Adverse events were observed in 19.5% after DGW but were not related to DGW technique. Conclusions DGW technique using UDLC during EUS-guided interventions was technically feasible and safe. In addition to multiple drainage insertion, it can potentially support complex EUS-guided interventions.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-020-06345-9