Abstract:

This study systematically reviews the advances in the application of endoscopic ultrasonography (EUS) in both portal and non-portal vascular interventions. EUS-guided sclerotherapy and coil embolization effectively occlude perforating vessels in esophageal, gastric, and ectopic varices, significantly reducing recurrence rates—particularly in refractory cases and patients with large shunt pathways. Moreover, EUS-guided portal pressure measurement achieves a technical success rate of 95% and demonstrates strong correlation with hepatic venous pressure gradient, showing potential as a non-invasive alternative. Meanwhile, EUS-guided fine-needle aspiration enables minimally invasive biopsy for definitive diagnosis of portal vein thrombi, with no complications reported. In non-portal vascular interventions, EUS provides precise therapeutic solutions for refractory lesions by embolizing bleeding ulcers, pseudoaneurysms, and feeding vessels of gastrointestinal stromal tumors. Although current evidence is predominantly derived from small-scale studies, the safety and efficacy of EUS-guided vascular intervention (EUS-VI) have been preliminarily validated. Future research should focus on large-scale randomized controlled trials to further evaluate and optimize technical standards, ultimately establishing EUS-VI as a first-line diagnostic and therapeutic option for vascular lesions.

Key words: Endoscopic ultrasonography, Vascular intervention, Portal hypertension, Portal pressure measurement