Sclerosing agents for use in GI endoscopy

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of gastrointestinal endoscopy. Evidence-based methodology is used, with a MEDLINE, literature search to identify pertinent clinical studies on the topic and a MAUDE (Manufacturer and User Facility Device Experience Database [Food and Drug Administration Center for Devices and Radiological Health]) database search to identify the reported complicalions of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent refrences cited by the identified studies. Controlled clinical trials are emphasized; but, in many cases, data from randomized controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE, Technology Committee, and are reviewed and edited by the committee as a whole, and then approved by the governing board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through November 2006 by using the following key phrases: "esophageal varices," "gastric varices," "gastrointestinal bleeding," "gastrointestinal fistula," and "sclerosing solutions." The commonly used sclerosing agents were also used as key words. Permutations of these keywords and phrases were performed to narrow the search. Additional references were obtained from the bibliographies of identified articles and through an Internet search engine. Emphasis was given, in all cases, to randomized controlled trials and, when necessary, to review articles from recognized experts. Finally a search of the MAUDE database was made for reported adverse events. Practitioners should continue to monitor the medical literature for subsequent data about The efficacy, safety and socioeconomic aspects of these technologies. Technology Status Evaluation Reports scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.