Systematic review: endoscopic and imaging‐based techniques in the assessment of portal haemodynamics and the risk of variceal bleeding

Sgouros, Spiros; Vasiliadis, K; Pereira, Stephen P.

doi:10.1111/j.1365-2036.2009.04135.x

Cited by 13 publications

(9 citation statements)

References 98 publications

(134 reference statements)

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“…There have been a number of studies that have demonstrated several key strategies for treating these complex patients. 12 Most recently, the AASLD proposed a set of guidelines for the management of cirrhotic patients presenting with upper GI haemorrhage. 5 In the present study, we postulated that even with an abundance of evidence for best practices, care of cirrhotic patients with GI bleeding remains inconsistent and suboptimal.…”

Section: Discussionmentioning

confidence: 99%

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Johnson

Spier

Leff

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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Section: Discussionmentioning

confidence: 99%

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Johnson

Spier

Leff

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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“…Prospective studies in compensated cirrhosis [56,57] initially suggested a good discriminating ability. Nonetheless, validation studies in subsequent series failed to confirm an adequate accuracy for varices prediction.…”

Section: Ultrasound and Colour-doppler-ultrasoundmentioning

confidence: 99%

Non-Invasive Diagnostic and Prognostic Evaluation of Liver Cirrhosis and Portal Hypertension

et al. 2011

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Abstract. Cirrhosis is the final stage of most of chronic liver diseases, and is almost invariably complicated by portal hypertension, which is the most important cause of morbidity and mortality in these patients. This review will focus on the non-invasive methods currently used in clinical practice for diagnosing liver cirrhosis and portal hypertension. The first-line techniques include physical examination, laboratory parameters, transient elastography and Doppler-US. More sophisticated imaging methods which are less commonly employed are CT scan and MRI, and new technologies which are currently under evaluation are MR elastography and acoustic radiation force imaging (ARFI). Even if none of them can replace the invasive measurement of hepatic venous pressure gradient and the endoscopic screening of gastroesophageal varices, they notably facilitate the clinical management of patients with cirrhosis and portal hypertension, and provide valuable prognostic information.

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“…Yet a considerable percentage of patients are not managed successfully, having recurrent variceal bleeding [22, 23]. EUS has emerged as a valuable tool for the diagnosis, treatment planning, evaluation of treatment success, and estimation of recurrent bleeding potential, being able to visualize varices, perforating, and collateral veins, thus allowing to predict varices with a high risk for (recurrent) bleeding [24–26]. In the last years, EUS is continuously emerging as a therapeutic method for the management of upper GI varices, as guidance for injection therapy and coiling, or their combination.…”

Section: Resultsmentioning

confidence: 99%

EUS-Guided Vascular Procedures: A Literature Review

Bokun

Grgurević

Kujundžić

et al. 2013

Gastroenterology Research and Practice

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Endoscopic ultrasound (EUS) is continuously stepping into the therapeutic arena, simultaneously evolving in different directions, such as the management of pancreatic and biliary diseases, celiac neurolysis, delivering local intratumoral therapy, and EUS-guided endosurgery. EUS-guided vascular procedures are also challenging, considering the variety of vascular pathology, proximity of the vascular structures to the GI tract wall, high resolution, and real-time guidance offering an attractive access route and precise delivery of the intervention. The literature on vascular therapeutic EUS demonstrates techniques for the management of upper GI variceal and nonvariceal bleeding, pseudoaneurysms, and coiling and embolization procedures, as well as the creation of intrahepatic portosystemic shunts. The paucity of studies, diversity of study designs, and the number of animal model studies hamper a systematic approach to the conclusion and decision making important to clinicians and healthcare policy makers. Nevertheless, theoretical benefits and findings up to date concerning technical feasibility, efficacy, and safety of the procedures drive further research and development in this rather young therapeutic arena.

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Systematic review: endoscopic and imaging‐based techniques in the assessment of portal haemodynamics and the risk of variceal bleeding

Cited by 13 publications

References 98 publications

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study

Non-Invasive Diagnostic and Prognostic Evaluation of Liver Cirrhosis and Portal Hypertension

EUS-Guided Vascular Procedures: A Literature Review

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