Color Doppler endoscopic ultrasonography in identifying groups at a high-risk of recurrence of esophageal varices after endoscopic treatment

Kuramochi, Akira; Imazu, Hiroo; Kakutani, Hiroshi; Uchiyama, Yuya; Hino, Shoryoku; Urashima, Mitsuyoshi

doi:10.1007/s00535-006-1992-x

Cited by 41 publications

(30 citation statements)

References 23 publications

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“…Investigators have reported the anatomical and/or hemodynamic factors related to EV as the predictive parameters for recurrence: severe-type peri-esophageal collateral veins and large perforating veins of the esophagus [27], poor development of para-esophageal veins [28], the high velocity and branch type in the left gastric vein [29], and a posttreatment area of submucosal vessels in the cardia [16]. The present study reported that no significant relation between MML and EV recurrence exists, suggesting the importance of a local factor and not a systemic factor to predict post-treatment EV recurrence.…”

Section: Discussionmentioning

confidence: 99%

Constraining Effect of Mild Portal Hypertension against the Negative Influence of Muscle Mass Loss in Cirrhosis after Esophageal Variceal Eradication

Kobayashi¹,

Maruyama²,

Kiyono³

et al. 2017

Clinical-Investigation

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Background: To elucidate the role of muscle mass loss (MML) in the long-term outcome of cirrhosis after the endoscopic eradication of esophageal varices (EV). Methods and findings:This is a subgroup analysis of 82 prospectively enrolled cirrhosis patients with eradicated EV. A severe portal hypertension (PH) was defined by post-treatment hepatic venous pressure gradient ≥12 mmHg. MML was assessed by skeletal muscle index at the L3 lesion (cm 2 /m 2 ) with the cut-off values of 38 for women and 42 for men (median observation period, 37.4 months). Twenty-four patients (29.3%) had MML. Multivariate analysis showed that a presence of hepatocellular carcinoma (P<0.0001) and a presence of MML (P=0.002) were significant prognostic factors. In the cohort with severe PH, the survival rate was significantly lower in patients with MML than in those without. However, in the cohort without severe PH, the survival rate showed no difference between patients with MML (100% at 1year, 50% at 3 years and 5 years) and those without (92.3% at 1 year and 3 years, 71.8% at 5 years; P=0.278). Conclusions:MML is an independent prognostic factor after the eradication of EV in cirrhosis, and the mild PH exerts a constraining effect against the negative influence of MML.

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Section: Discussionmentioning

confidence: 99%

Constraining Effect of Mild Portal Hypertension against the Negative Influence of Muscle Mass Loss in Cirrhosis after Esophageal Variceal Eradication

Kobayashi¹,

Maruyama²,

Kiyono³

et al. 2017

Clinical-Investigation

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“…[4] In another study, Kuramochi et al , also showed that LGV hemodynamics can predict the early recurrence of esophageal varices, after eradication of varices by endoscopic sclerotherapy or endoscopic variceal ligation. [10]…”

Section: Discussionmentioning

confidence: 99%

Color Doppler evaluation of left gastric vein hemodynamics in cirrhosis with portal hypertension and its correlation with esophageal varices and variceal bleed

Adithan

Bhuvaneswari

Sundarajan

et al. 2010

Indian Journal of Radiology and Imaging

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Aim:The purpose of this study was to assess the value of Doppler evaluation of left gastric vein hemodynamics when monitoring portal hypertension patients, by correlating Doppler ultrasonography (USG) parameters with the severity of esophageal varices and occurrence of variceal bleeding.Methods:This study was carried out on 100 patients using Doppler USG and endoscopy. Forty-seven of these were patients with cirrhosis with portal hypertension, who had not had a recent variceal bleed (group 1) and 26 were patients with cirrhosis with portal hypertension, with a recent history of bleeding (group 2). The control group comprised of 27 subjects who did not have liver disease or varices on endoscopy (group 3). The hemodynamic parameters, namely the diameter of the left gastric vein and the direction and flow velocity in the vessel, were compared in these groups, with the grade of esophageal varices.Results:Hepatofugal flow velocity in the left gastric vein was higher in patients with large-sized varices compared to those patients with small-sized varices (P < 0.001). The left gastric vein hepatofugal flow velocity was higher in patients with a recent variceal bleed than in those patients without a history of a recent variceal bleed (P < 0.0149). Large-sized varices were more commonly found in patients with a history of a recent variceal bleed (P < 0.0124).Conclusion:Left gastric vein hemodynamics were found to correlate with the severity of the varices and the occurrence of recent variceal bleed in patients with cirrhosis with portal hypertension. Evaluation of the left gastric vein portal dynamics could be helpful in monitoring the progress of the disease in these patients.

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“…The branching pattern and blood flow velocity of the left gastric vein has also been shown to be associated with large EV . In one study of patients treated for EV, EUS findings of a hepatofugal flow velocity of greater than 12 cm/s or an anterior branch dominant pattern were classified as a high‐risk group and had recurrence of EV within 6 months . Although promising, widespread use of these parameters is limited by lack of data for normal ranges that would need to be validated in larger studies.…”

Section: Eus and Esophageal Varicesmentioning

confidence: 99%

Endoscopic ultrasound and the liver: current applications and beyond

Shah

Baron

2018

J Hepato Biliary Pancreat

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The diagnosis and management of many gastrointestinal conditions has been augmented by the development of endoscopic ultrasound. Its role in the diagnosis and management of liver disease has been somewhat limited, but with the rapid development of therapeutic advancements it has quickly emerged as a useful tool in the management of complex hepatic conditions. This includes its use in the management of complications of portal hypertension as well as its use in liver lesions and cancer. In this paper, we review case studies, case series and trials for hepatic applications of endoscopic ultrasound to provide an overview of its utilization in this field and demonstrating its more novel applications for future use.

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Color Doppler endoscopic ultrasonography in identifying groups at a high-risk of recurrence of esophageal varices after endoscopic treatment

Abstract: These results suggest that patients showing anterior branch dominance and rapid hepatofugal flow velocity in the LGV on CD-EUS examination may have a high risk of an early recurrence of esophageal varices.

Cited by 41 publications

References 23 publications

Constraining Effect of Mild Portal Hypertension against the Negative Influence of Muscle Mass Loss in Cirrhosis after Esophageal Variceal Eradication

Constraining Effect of Mild Portal Hypertension against the Negative Influence of Muscle Mass Loss in Cirrhosis after Esophageal Variceal Eradication

Color Doppler evaluation of left gastric vein hemodynamics in cirrhosis with portal hypertension and its correlation with esophageal varices and variceal bleed

Endoscopic ultrasound and the liver: current applications and beyond

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