Mild collateral varices and a fundic plexus without perforating veins on EUS predict endoscopic non-recurrence of esophageal varices after EVL.

ABSTRACT

BACKGROUND/AIMS: 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). METHODOLOGY: 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.