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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predictive factors of worsening of esophageal varices after balloon-occluded retrograde transvenous obliteration in patients with gastric varices
American Journal of Gastroenterology, Volume 104, No. 9, Year 2009
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Description
OBJECTIVES:Although balloon-occluded retrograde transvenous obliteration (B-RTO) is useful for management of gastric varices, worsening of esophageal varices (EV) is the most important complication of B-RTO. The predictive factors of worsening of EV have not been evaluated in detail. This study was designed to evaluate the role of endoscopic color Doppler ultrasonography (ECDUS) in the detection of possible risk factors for worsening of EV after B-RTO.METHODS:A total of 39 cirrhotic patients with high-risk gastric varices successfully treated by B-RTO were included in this study. All patients underwent ECDUS before B-RTO to measure hemodynamic parameters of gastric varices and regular endoscopic follow-up after B-RTO to detect worsening of EV. The risk factors were analyzed by Cox's proportional hazards regression.RESULTS:Worsening of EV was found in 24 (61.5%) patients. The presence of esophageal varices before B-RTO and a lower degree of liver dysfunction (Child-Pugh class B) were statistically independent risk factors for worsening of EV after B-RTO (hazard ratio, HR, 5.81, 95% confidence interval, CI, 1.71-19.77 and HR 2.92, 95% CI: 1.21-7, respectively). High resistance index (0.24), measured by ECDUS, is also an independent risk factor for worsening of EV after B-RTO (HR 4.06, 95% CI: 1.14-14.38) and increase in resistance index is associated with worsening of EV (P for trend0.028).CONCLUSIONS:The presence of EV, higher Child-Pugh class, and higher resistance index assessed by ECDUS before B-RTO were significant risk factors for worsening of EV after B-RTO. © 2009 by the American College of Gastroenterology.
Authors & Co-Authors
Elsamman, Mahmoud Kamal
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Egypt, Sohag
Sohag University
Fujiwara, Yasuhiro
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Kameda, Natsuhiko
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Okazaki, Hirotoshi
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Tanigawa, Tetsuya
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Shiba, Masatsugu
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Tominaga, Kazunari
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Watanabe, Toshio
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Oshitani, Nobuhide
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Arafa, Usama Ahmed
Egypt, Sohag
Sohag University
El-Sayed, Adel A.
Egypt, Sohag
Sohag University
Nakamura, Kenji
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Arakawa, Tetsuo
Japan, Osaka
Osaka Metropolitan University Graduate School of Medicine
Statistics
Citations: 25
Authors: 13
Affiliations: 2
Identifiers
Doi:
10.1038/ajg.2008.140
e-ISSN:
15720241
Research Areas
Environmental
Maternal And Child Health
Study Design
Cohort Study