title: Role of EUS evaluation after endoscopic eradication of esophageal varices with band ligation.
abstract: OBJECTIVE
  Variceal recurrence after endoscopic band ligation (EBL) for secondary prophylaxis is a frequent event. Some studies have reported a correlation between variceal recurrence and variceal rebleeding with the EUS features of paraesophageal vessels. A prospective observational study was conducted to correlate EUS evaluation of paraesophageal varices, azygos vein, and thoracic duct with variceal recurrence after EBL variceal eradication in patients with cirrhosis.
  
  
  METHODS
  EUS was performed before and 1 month after EBL variceal eradication. Paraesophageal varices, azygos vein, and thoracic duct maximum diameters were evaluated in predetermined anatomic stations. After EBL variceal eradication, patients were submitted to endoscopic examinations every 3 months for 1 year. We looked for EUS features that could predict variceal recurrence.
  
  
  RESULTS
  Thirty patients completed a 1-year endoscopic follow-up. Seventeen patients (57%) presented variceal recurrence. There was no correlation between azygos vein and thoracic duct diameter with variceal recurrence. Larger paraesophageal varices predicted variceal recurrence in both evaluation periods. Paraesophageal varices diameters that best correlated with variceal recurrence were 6.3 mm before EBL (52.9% sensitivity, 92.3% specificity, and .749 area under the receiver operating characteristic curve [AUROC]) and 4 mm after EBL (70.6% sensitivity, 84.6% specificity, and .801 AUROC).
  
  
  CONCLUSIONS
  We conclude that paraesophageal varices diameter measured by EUS predicts variceal recurrence within 1 year after EBL variceal eradication. Paraesophageal diameter after variceal eradication is a better recurrence predictor, because it has a lower cut-off parameter, higher sensitivity, and higher AUROC.
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Fred Olavo Aragão Andrade
authors.initials: FO
authors.lastname: Carneiro
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Felipe Alves
authors.initials: FA
authors.lastname: Retes
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Sérgio Eiji
authors.initials: SE
authors.lastname: Matuguma
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Débora Vieira
authors.initials: DV
authors.lastname: Albers
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Dalton Marques
authors.initials: DM
authors.lastname: Chaves
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcos Eduardo Lera
authors.initials: ME
authors.lastname: Dos Santos
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Herman
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Eleazar
authors.initials: E
authors.lastname: Chaib
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Carneiro D'Albuquerque
authors.affiliation: Gastrointestinal Endoscopy Unit, Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
authors.forename: Fauze
authors.initials: F
authors.lastname: Maluf Filho
mesh_terms: D019540:Area Under Curve; D001401:Azygos Vein / Q000000981:diagnostic imaging*; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D004945:Esophagoscopy; D004947:Esophagus / Q000098:blood supply*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D055502:Secondary Prevention; D013897:Thoracic Duct / Q000000981:diagnostic imaging*