title: Mild collateral varices and a fundic plexus without perforating veins on EUS predict endoscopic non-recurrence of esophageal varices after EVL.
abstract: OBJECTIVE
  This study assessed the risk of recurrence of esophageal varices by evaluating the severity of esophageal collateral and cardiac vascular structures in patients with portal hypertension on EUS before endoscopic variceal ligation (EVL).
  
  
  METHODS
  Twenty-three consecutive patients with esophageal varices at high risk for bleeding were studied. Simultaneous conventional endoscopy and EUS were performed before endoscopic variceal ligation. Based on EUS findings, vascular structures in the esophageal wall and gastric cardia were classified into two grades, mild and severe, and the relationship between the EUS findings and the esophageal varices recurrence rate was analyzed.
  
  
  RESULTS
  Recurrence of esophageal varices was detected endoscopically in 16 (69.6%) of the 23 patients within 2 years after EVL. Patients with non-recurrent esophageal varices after EVL were more likely to have mild-grade collateral veins, perforating veins, and a fundic plexus before treatment than those with recurrence.
  
  
  CONCLUSIONS
  Mild collateral varices and a fundic plexus without perforating veins on EUS before EVL predict long-term endoscopic non-recurrence of esophageal varices after EVL.
authors.affiliation: The Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan. k-kume@med.uoeh-u.ac.jp
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kume
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuki
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
mesh_terms: D000328:Adult; D000368:Aged; D003097:Collateral Circulation; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004947:Esophagus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012008:Recurrence