title: Variceal recurrence after endoscopic sclerotherapy associated with the perforating veins in lower esophagus independently.
abstract: OBJECTIVE
  The perforating veins as a lateral blood supply route for esophageal varices in lower esophagus are associated with the recurrence of esophageal varices after sclerotherapy, but not vessels at the esophagogastric junction as an ascending blood supply route. To date, however, frequency of association perforating veins alone with variceal recurrence has not been investigated. To clarify the influence of perforating veins alone on variceal recurrence after endoscopic injection sclerotherapy, we studied the prevalence of variceal recurrence in patients with perforating veins detected by endoscopic ultrasonography after treatment.
  
  
  METHODS
  Forty-two patients who underwent injection sclerotherapy and received endoscopic ultrasonography after treatment to evaluate the effect on the collaterals around the esophagus, were studied. Subjects were classified in four groups according to endosonographic findings as follows: group A: perforating veins (+) and vessels at esophagogastric junction (+), group B: perforating veins (+) and vessels at esophagogastric junction (-), group C: perforating veins (-) and vessels at esophagogastric junction (+), group D: perforating veins (-) and vessels at esophagogastric junction (-).
  
  
  RESULTS
  Variceal recurrence was observed in 60% (6/10) of patients in group A, 64.3% (9/14) of patients in group B, 33.3% (1/3) of patients in group C, 0% (0/15) of patients in group D, respectively. The prevalence of variceal recurrence was compared between the 4 groups. No significant difference between group A or C and B was noted, and there was a significant difference between group A or B and D.
  
  
  CONCLUSIONS
  These results suggested that perforating veins are highly associated with variceal recurrence after sclerotherapy even if perforating veins are independent.
authors.affiliation: Department of Internal Medicine 2, Fukushima Medical University School of Medicine, Hikarigaoka, Fukushima City, Japan. goro-s@fmu.ac.jp
authors.forename: Goro
authors.initials: G
authors.lastname: Shibukawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.forename: Ayako
authors.initials: A
authors.lastname: Saito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.forename: Go
authors.initials: G
authors.lastname: Yamamoto
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Oyama
authors.forename: Naoto
authors.initials: N
authors.lastname: Sato
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugino
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Suzuki
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sato
mesh_terms: D004939:Esophageal Perforation / Q000150:complications; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015911:Sclerotherapy / Q000379:methods*