Endoscopic Color Doppler Ultrasonography for Esophagogastric  Varices

Sato, Takahiro; Yamazaki, Katsu

doi:10.1155/2012/859213

Cited by 6 publications

(7 citation statements)

References 54 publications

(51 reference statements)

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“…Para-ECVs have also been studied, and a histopathological causal relationship has been demonstrated by the existence of both peri-, and para-ECVs [27]. Furthermore, these ECVs often communicate with esophageal varices via PV, and such relationships can be observed in detail on EUS [14,15,24,27] (Figure 5c). According to studies of the blood flow direction of the PV using color Doppler EUS, it was found that most PV in the lower esophagus served as inflow pathways [14,15].…”

Section: Evaluation Of the Hemodynamics Of Esophageal Variesmentioning

confidence: 96%

“…When performing electronic radial-arrayed EUS, it is difficult to achieve detailed esophageal intramural and extramural evaluation, which is possible with UMP. However, the color Doppler function enables identification of the direction of the blood flow of perforating veins communicating between the esophageal varices and extramural blood vessels, and it also aids in understanding the hemodynamics surrounding the esophageal varices in greater detail [14,15] (Figure 3). Perforating veins with blood flow into esophageal varices may remain after treatment and contribute to recurrence, which suggests the importance of eliminating these at the time of treatment.…”

Section: Eus Procedures For the Diagnosis Of Esophageal Varicesmentioning

confidence: 99%

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The Role of Endoscopic Ultrasound for Esophageal Varices

et al. 2020

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Esophageal varices are caused by the development of collateral circulation in the esophagus as a result of portal hypertension. It is important to administer appropriate preventive treatment because bleeding varices can be fatal. Esophageal varices have complex and diverse hemodynamics, and there are various variations for each case. Endoscopic ultrasound (EUS) can estimate the hemodynamics of each case. Therefore, observation by EUS in esophageal varices provides useful information, such as safe and effective treatment selection, prediction of recurrence, and appropriate follow-up after treatment. Although treatment for the esophagogastric varices can be performed without EUS imaging, understanding the local hemodynamics of the varices using EUS prior to treatment will lead to more safe and effective treatment. EUS observation is an indispensable tool for thorough variceal care.

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Section: Evaluation Of the Hemodynamics Of Esophageal Variesmentioning

confidence: 96%

Section: Eus Procedures For the Diagnosis Of Esophageal Varicesmentioning

confidence: 99%

The Role of Endoscopic Ultrasound for Esophageal Varices

et al. 2020

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“…In order to identify factors that contributed to recurrence of varices and bleeding after endoscopic treatment some authors have also used color Doppler EUS. The association of Doppler to ultrasound images obtained by EUS allows both the visualization of varices and its collaterals and the understanding of the hemodynamics of the portal venous system and even the effects of endoscopic and pharmacological therapeutics for esophageal varices[ 41 ]. In a study by Hino et al[ 42 ] the color Doppler EUS was used to study the hemodynamics changes and morphology pattern of the left gastric vein (the main feeder vessel of esophageal varices).…”

Section: Eus and Endoscopic Therapy Of Gastroesophageal Varicesmentioning

confidence: 99%

“…The endoscopic diagnosis of high risk for bleeding of gastric varices is not always easy to assess, and sometimes they are mistaken for large gastric folds or submucosal tumors. The magnetic resonance and CT allow the visualization of the entire portal venous system, however the accuracy of these techniques in distinguishing between submucosal gastric varices and perigastric collateral veins remains limited[ 41 ].…”

Section: Eus and Endoscopic Therapy Of Gastroesophageal Varicesmentioning

confidence: 99%

Endoscopic ultrasonography - emerging applications in hepatology

Magalhães¹,

Monteiro²,

Xavier³

et al. 2017

WJGE

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The inspection of the liver is a valuable part of the upper endoscopic ultrasonography (EUS) studies, regardless of the primary indication for the examination. The detailed images of the liver segments provided by EUS allows the use of this technique in the study of parenchymal liver disease and even in the diagnosis and classification of focal liver lesions. EUS has also emerged as an important tool in understanding the complex collateral circulation in patients with portal hypertension and their clinical and prognostic value. Recently, EUS-guided portal vein catheterization has been performed for direct portal pressure measurement as an alternative method to evaluate portal hemodynamics. In this review, the authors summarize the available evidence regarding the application of EUS to patients with liver diseases and how we can apply it in our current clinical practice.

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“…Although endoscopic findings are typically evaluated with the naked eye, this approach cannot be used to assess deep collateral vessels to identify the RCS. Therefore, endoscopic ultrasonography, which was developed to evaluate diseases of the mediastinum, is used to visualize the collateral channels that surround the distal esophagus and upper stomach[ 3 - 10 ], and may enhance variceal detection and improve therapeutic targeting[ 11 - 20 ]. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS) are the two major techniques used in endoscopic EV therapy[ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices

Zhang

2017

WJG

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AIMTo investigate the efficacy and safety of a combination of sufentanil and propofol injection in patients undergoing endoscopic injection sclerotherapy (EIS) for esophageal varices (EVs).METHODSPatients with severe EVs who underwent EIS with sufentanil and propofol anesthesia between April 2016 and July 2016 at our hospital were reviewed. Although EIS and sequential therapy were performed under endotracheal intubation, we only evaluated the efficacy and safety of anesthesia for the first EIS procedure. Patients were intravenously treated with 0.5-1 μg/kg sufentanil. Anesthesia was induced with 1-2 mg/kg propofol and maintained using 2-5 mg/kg per hour of propofol. Information, regarding age, sex, weight, American Association of Anesthesiologists (ASA) physical status, Child-Turcotte-Pugh (CTP) classification, indications, preanesthetic problems, endoscopic procedure, successful completion of the procedure, anesthesia time, recovery time, and anesthetic agents, was recorded. Adverse events, including hypotension, hypertension, bradycardia, and hypoxia, were also noted.RESULTSPropofol and sufentanil anesthesia was provided in 182 procedures involving 140 men and 42 women aged 56.1 ± 11.7 years (range, 25-83 years). The patients weighed 71.4 ± 10.7 kg (range, 45-95 kg) and had ASA physical status classifications of II (79 patients) or III (103 patients). Ninety-five patients had a CTP classification of A and 87 had a CTP classification of B. Intravenous anesthesia was successful in all cases. The mean anesthesia time was 33.1 ± 5.8 min. The mean recovery time was 12.3 ± 3.7 min. Hypotension occurred in two patients (1.1%, 2/182). No patient showed hypertension during the endoscopic therapy procedure. Bradycardia occurred in one patient (0.5%, 1/182), and hypoxia occurred in one patient (0.5%, 1/182). All complications were easily treated with no adverse sequelae. All endoscopic procedures were completed successfully.CONCLUSIONThe combined use of propofol and sufentanil injection in endotracheal intubation-assisted EIS for EVs is effective and safe.

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Endoscopic Color Doppler Ultrasonography for Esophagogastric Varices

Cited by 6 publications

References 54 publications

The Role of Endoscopic Ultrasound for Esophageal Varices

The Role of Endoscopic Ultrasound for Esophageal Varices

Endoscopic ultrasonography - emerging applications in hepatology

Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices

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