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• W2020199633 abstract "To the Editor: We read with interest the recent article by Moyer et al1Moyer M.T. Stack Jr., B.C. Mathew A. Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS needle.Gastrointest Endosc. 2006; 64: 789-792Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar on combined antegrade and retrograde dilation of complete esophageal obstruction utilizing a needle knife and EUS needle in respective cases. We commend the authors on their innovative approach. We agree that use of an EUS needle to “puncture” the obstruction to allow guidewire access is an ideal approach. It avoids use of cautery, and can be guided fluoroscopically. We initially described this approach in a previous letter to the Editor2McGrath K. Brazer S. Combined antegrade and retrograde dilation: a new endoscopic technique in the management of complex esophageal obstruction.Gastrointest Endosc. 2002; 56: 163-164PubMed Google Scholar in response to the Bueno et al3Bueno R. Swanson S.J. Jaklitsch M.T. et al.Combined antegrade and retrograde dilation: a new endoscopic technique in the management of complex esophageal obstruction.Gastrointest Endosc. 2001; 54: 368-372Abstract Full Text Full Text PDF PubMed Scopus (100) Google Scholar experience using the combined antegrade and retrograde technique. We were able to cross a 2-cm long obstruction with an EUS needle by using 2 opposing endoscopes—a less cumbersome technique than use of a rigid esophagoscope—which could be performed with the patient under moderate sedation. Moyer et al1Moyer M.T. Stack Jr., B.C. Mathew A. Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS needle.Gastrointest Endosc. 2006; 64: 789-792Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar describe traversing a 3-cm obstruction with an EUS needle, and believe that crossing longer obstructions may be possible. We agree and note that fluoroscopic guidance is necessary to increase the safety margin; however, risk will likely increase with the length of the obstruction. We recently applied our technique of EUS needle use for successful reestablishment of luminal patency to complete colonic obstruction.4Kaushik N. Rubin J. McGrath K. Treatment of benign complete colonic anastomotic obstruction by using an endoscopic rendezvous technique.Gastrointest Endosc. 2006; 63: 727-730Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS needleGastrointestinal EndoscopyVol. 64Issue 5PreviewEsophageal occlusion is typically caused by cancer or postradiation changes; it is difficult to treat, with poor surgical outcomes. The combined antegrade retrograde dilation (CARD) method has been used to endoscopically restore the esophageal lumen after complete occlusion by cancer or postradiation changes, with good preliminary results. Reproducing this technique and improving its speed and convenience would be advances in treating this difficult clinical problem. Full-Text PDF" @default.
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• W2020199633 title "Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS needle" @default.
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