VIDEOGIE Todd H. Baron, MD, G. S. Raju, MD, Editors for VideoGIE
Endoscopic optical coherence tomography as a tool to evaluate successful myotomy after a peroral endoscopic myotomy
Figure 1. Optical coherence tomography in a patient with normal esophagus versus a patient with achalasia after a posterior peroral endoscopic myotomy (POEM).
Optical coherence tomography (OCT) provides imaging depth down to 3 mm and resolution of 7 mm over a 6-cm length over a 90 second scan. It is used to analyze tissue microstructure to scan for any potential abnormalities in the esophagus. As of now, the utility of OCT in assessing the esophageal muscular layers in achalasia patients after a peroral endoscopic myotomy (POEM) procedure has not been assessed. We present a case in which this device was used for this indication. A 51-year-old woman with a history of achalasia underwent a posterior POEM with subsequent clinical resolution of her symptoms. Two months later, OCT was performed to confirm the destruction of the muscular layers. Her symptoms had resolved. OCT was performed to confirm the destruction of the muscular layers. A full scan at 33 cm of the esophagus with a 20-mm optical probe at 18 pounds per square inch revealed a break in the muscular layers in the posterior wall consistent with
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store. www.giejournal.org
myotomy from a previous POEM (Fig. 1; Video 1, available at www.giejournal.org). OCT can be useful for evaluating the integrity of muscular layers after a POEM. Further studies are required to confirm the efficacy of endoscopic myotomy in real time and possibly to predict the long-term clinical success of the procedure. DISCLOSURE The following author disclosed financial relationships relevant to this publication: Michel Kahaleh is a consultant to Boston Scientific and Xlumina; conducts research for Gore, MI Tech and Pinnacle; and is a consultant to and conducts research for Maunakea. All other authors disclosed no financial relationships relevant to this publication. Viviana Parra, MD, Prashant Kedia, MD, Hitomi Minami, MD, Reem Z. Sharaiha, MD, Michel Kahaleh, MD, FASGE, Division of Gastroenterology and Hepatology, Weil Cornell Medical College, Cornell University, New York, New York, USA
http://dx.doi.org/10.1016/j.gie.2014.07.011
Volume 81, No. 5 : 2015 GASTROINTESTINAL ENDOSCOPY 1251
Endoscopic optical coherence tomography as a tool to evaluate successful myotomy after a peroral endoscopic myotomy
Figure 1. Optical coherence tomography in a patient with normal esophagus versus a patient with achalasia after a posterior peroral endoscopic myotomy (POEM).
Optical coherence tomography (OCT) provides imaging depth down to 3 mm and resolution of 7 mm over a 6-cm length over a 90 second scan. It is used to analyze tissue microstructure to scan for any potential abnormalities in the esophagus. As of now, the utility of OCT in assessing the esophageal muscular layers in achalasia patients after a peroral endoscopic myotomy (POEM) procedure has not been assessed. We present a case in which this device was used for this indication. A 51-year-old woman with a history of achalasia underwent a posterior POEM with subsequent clinical resolution of her symptoms. Two months later, OCT was performed to confirm the destruction of the muscular layers. Her symptoms had resolved. OCT was performed to confirm the destruction of the muscular layers. A full scan at 33 cm of the esophagus with a 20-mm optical probe at 18 pounds per square inch revealed a break in the muscular layers in the posterior wall consistent with
This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store. www.giejournal.org
myotomy from a previous POEM (Fig. 1; Video 1, available at www.giejournal.org). OCT can be useful for evaluating the integrity of muscular layers after a POEM. Further studies are required to confirm the efficacy of endoscopic myotomy in real time and possibly to predict the long-term clinical success of the procedure. DISCLOSURE The following author disclosed financial relationships relevant to this publication: Michel Kahaleh is a consultant to Boston Scientific and Xlumina; conducts research for Gore, MI Tech and Pinnacle; and is a consultant to and conducts research for Maunakea. All other authors disclosed no financial relationships relevant to this publication. Viviana Parra, MD, Prashant Kedia, MD, Hitomi Minami, MD, Reem Z. Sharaiha, MD, Michel Kahaleh, MD, FASGE, Division of Gastroenterology and Hepatology, Weil Cornell Medical College, Cornell University, New York, New York, USA
http://dx.doi.org/10.1016/j.gie.2014.07.011
Volume 81, No. 5 : 2015 GASTROINTESTINAL ENDOSCOPY 1251
