Hemodynamic assessment of the left gastric vein in patients with esophageal varices with color Doppler EUS: Factors affecting development of esophageal varices

Hino, Shoryoku; Kakutani, Hiroshi; Ikeda, Keiichi; Uchiyama, Yuya; Sumiyama, Kazuki; Kuramochi, Akira; Kitamura, Yoko; Matsuda, Koji; Arakawa, Hiroshi; Kawamura, Muneo; Masuda, Kouji; Suzuki, Hiroaki

doi:10.1067/mge.2002.122333

Cited by 68 publications

(57 citation statements)

References 16 publications

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“…Sato et al [7] observed the presence of perforating veins between peri-EV and para-EV with Levovist ECDUS, and meanwhile, he found the bidirectional blood flow of peri-EV and para-EV, which included the directions from para-EV to peri-EV and from peri-EV to para-EV, as well as mixed type that presented both blood flow directions. This may explain why previous para-EV studies about the recurrence risk of post-esophageal varices treatment remain controversial [20,23,24] .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of paraesophageal varices: A study with 64-row multidetector computed tomograghy portal venography

Zhao¹,

He²,

Chen³

2008

WJG

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AIM:To identify the characteristics of morphology, location and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomography (MDCT). METHODS: Fifty-two of 501 patients with portal hypertensive cirrhosis accompanied with esophageal varices were selected for 64-row MDCT examination after the observation of para-EV. The CT protocol included unenhanced, arterial and portal phases with a slice thickness of 0.625 mm and a scanning field of 2 cm above the bifurcation to the lower edge of kidney. The CT portal venography (CTPV) was reformatted on AW4.3 workstation. The characteristics of origination, location, morphology and collateral circulation in para-EV were observed. RESULTS: Among the 52 cases of para-EV, 50 showed the originations from the posterior branch of left gastric vein, while the others from the anterior branch. Fifty cases demonstrated their locations close to the esophageal-gastric junction, and the other two cases were extended to the inferior bifurcation of the trachea. The circuitous pattern was observed in 16 cases, while reticulated pattern was seen in 36 cases. Collateral circulation identified 4 cases of single periesophageal varices (peri-EV) communication, 3 cases of single hemiazygous vein, one case of single inferior vena cava, 41 cases of mixed type (collateral communications of at least 2 of above mentioned types) and 3 cases of undetermined communications. Among all the cases, 43 patients showed the communications between para-EV and peri-EV, while hemiazygous vein (43 cases) and inferior vena cava (5 cases) were also involved. CONCLUSION: Sixty-four-row multidetector computed tomography portal venography could display the location, morphology, origin, and collateral types of para-EV, which provides important and referable information for clinical management and disease prognosis.

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Section: Discussionmentioning

confidence: 99%

Characteristics of paraesophageal varices: A study with 64-row multidetector computed tomograghy portal venography

Zhao¹,

He²,

Chen³

2008

WJG

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“…Our previous study demonstrated that blood fl ow in the perforating veins was usually directed towards the esophageal varices; thereby the perforating veins were playing the role of a supplying vein. 13 However, the frequency of 7.5 MHz used in the CD-EUS limits observations to only those veins with a large diameter. Further investigation, combined with the use of EUS at a higher frequency, may be required to address this issue.…”

Section: Discussionmentioning

confidence: 99%

“…The angle between the Doppler beam and the long axis of the vessel was adjusted to less than 60°. The branching patterns of the LGV were classifi ed into anterior branch dominance (type AD), non-dominance (type ND), and posterior branch dominance (type PD) according to previously used criteria 13,14 (Fig. 4).…”

Section: Patientsmentioning

confidence: 99%

“…We Branch patterns of the LGV were classifi ed into anterior branch dominance (type AD), non-dominance (type ND) and posterior branch dominance (type PD) according to the criteria previously used, 13,14 where dominance was defi ned as lack of one branch, or a ratio of the smaller branch diameter to the larger branch diameter of less than 0.75…”

Section: Endoscopic Treatment Of Esophageal Varicesmentioning

confidence: 99%

“…[10][11][12] The technique of EUS is noninvasive and can provide highresolution images of the collaterals in close proximity to the gut lumen. We have reported that EUS, using a convex scanner, can provide a longitudinal image of the left gastric vein (LGV), 13 which is the major feeder vessel for esophageal varices. Such an image allows the assessment of blood fl ow and a detailed morphological examination.…”

Section: Introductionmentioning

confidence: 99%

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