Gastrointestinal endoscopy · 2026
"Vanishing needle tract" in endoscopic ultrasound-guided tissue acquisition: definition, incidence, and risk factors in a large single-center cohort.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Komori Yasuhiro, Hijioka Susumu, Yagi Shin, Nagashio Yoshikuni, Harai Shota, Yamashige Daiki, Onuma Kazunori, Fujisaki Keita, Agarie Daiki, Okamoto Kohei, Fukuda Soma, Kuwada Masaru, Torres Joshua Josef, Ueda Keijiro, Fujimori Nao, Saito Yutaka, Ogawa Yoshihiro, Okusaka Takuji
Аннотация
BACKGROUND AND AIMS: In EUS-guided tissue acquisition (EUS-TA), the needle tip may occasionally become invisible on the EUS image during advancement. We named this phenomenon "vanishing needle tract" (VNT) and investigated its incidence, associated factors, and directional characteristics.
METHODS: This single-center retrospective study included cases of EUS-TA performed between September 2021 and December 2024. The occurrence and direction of VNT were recorded in the database by the performing endoscopist immediately after each procedure. The direction of VNT was defined by the needle disappearance and classified as clockwise VNT or counterclockwise VNT.
RESULTS: Of the 2094 lesions for which EUS-TA was performed during the study period, 1630 were analyzed. The pancreas was the most common target (60.2%), with a median lesion size of 20 mm. The puncture routes included the stomach (61.8%), duodenal bulb (17.0%), and the second portion of the duodenum (21.2%). The median number of punctures was 2 (range, 1-7). VNT occurred in 26.6% of cases, of which 75.8% were clockwise VNT. Significant risk factors for VNT included puncture via the duodenal bulb (P < .001), higher number of punctures (P < .001), and use of Franseen needles (P = .012).
CONCLUSIONS: VNT is a relatively common phenomenon occurring predominantly in the clockwise direction. It is more likely to occur in cases of limited maneuverability, as in the duodenal bulb, or multipoint needle contact, as with a Franseen needle. By defining this novel concept of VNT, our study contributes to the standardization of EUS-TA and future improvements in device design.
METHODS: This single-center retrospective study included cases of EUS-TA performed between September 2021 and December 2024. The occurrence and direction of VNT were recorded in the database by the performing endoscopist immediately after each procedure. The direction of VNT was defined by the needle disappearance and classified as clockwise VNT or counterclockwise VNT.
RESULTS: Of the 2094 lesions for which EUS-TA was performed during the study period, 1630 were analyzed. The pancreas was the most common target (60.2%), with a median lesion size of 20 mm. The puncture routes included the stomach (61.8%), duodenal bulb (17.0%), and the second portion of the duodenum (21.2%). The median number of punctures was 2 (range, 1-7). VNT occurred in 26.6% of cases, of which 75.8% were clockwise VNT. Significant risk factors for VNT included puncture via the duodenal bulb (P < .001), higher number of punctures (P < .001), and use of Franseen needles (P = .012).
CONCLUSIONS: VNT is a relatively common phenomenon occurring predominantly in the clockwise direction. It is more likely to occur in cases of limited maneuverability, as in the duodenal bulb, or multipoint needle contact, as with a Franseen needle. By defining this novel concept of VNT, our study contributes to the standardization of EUS-TA and future improvements in device design.