Study of hemodynamic changes in portal systemic shunts and their relation to variceal relapse after endoscopic variceal ligation combined with ethanol sclerotherapy

Abstract

Sonographic assessment of hemodynamic changes in portal systemic shunt could be useful for estimating the results of endoscopic treatment for esophageal varices.

Three-dimensional Doppler ultrasonographic evaluation of hemodynamic changes in the left gastric vein and hepatic artery resistive index before and after variceal band ligation

“…These results are in agreement with those of the study by Ito et al [3] on hemodynamic changes in portal systemic shunts and their relation to variceal relapse after EVL. They found that the significant parameters predicting variceal relapse in their study were the hepatopedal flow direction and a decrease in the LGV diameter.…”

Endoscopic hemostasis for bleeding gastric varices treated by combination of variceal ligation and sclerotherapy with N-butyl-2-cyanoacrylate

“…This study was not a controlled study, and we did not evaluate the hemodynamics of the varices because all cases were emergent. 31,41 A previous study demonstrated a successful initial hemostasis rate of gastric varices with EVL + EIS, 31 and this study resulted in an initial 1-week hemostasis rate of 88.9% (24/27) and a 5-year survival rate of 63.0% (17/27), indicating that EVL + EIS might be a suitable therapeutic strategy for bleeding gastric varices in emergency situations. The combination therapy used in this study might be advantageous for emergent hemostasis of bleeding gastric varices with EVL to stabilize vital signs and maintain a better visualization of the hemostasis, followed by permanent hemostasis with sclerotherapy with cyanoacrylate.…”

MR Evaluation of Portal Hypertensive Collateral Shunting Vessels for Predicting Outcome after Transjugular Intrahepatic Portosystemic Shunt

“…1,[9][10][11][12][13][14] Many researchers have investigated the relationships between diameter of the portal vein and portal pressure, 16 ‰ow direction, 17 development of the shunting vessels, 18 diameter of the shunting vessels and gastroesophageal bleeding, 19 or onset of encephalopathy. 20 Ito and associates 21 recently reported decreased diameter and hepatopetal ‰ow of the left gastric vein and the presence of non-variceal portosystemic shunt as predictive factors for variceal relapse after endoscopic therapies. Theseˆnd-ings suggest that measurements of portal system and portosystemic shunting collateral diameters may be useful to guide management of patients with portal hypertension.…”