scholarly journals Mo1532 – The Utility of Radiographic Evidence of Portosystemic Collateral Vessels to Improve the Baveno Vi Consensus Recommendations in the Non-Invasive Prediction of Esophageal Varices

2019 ◽  
Vol 156 (6) ◽  
pp. S-1334
Author(s):  
Michael Rosman ◽  
Chino Aneke-Nash ◽  
Maureen Whitsett ◽  
Ira M. Jacobson
Keyword(s):  
Esophageal Varices ◽  
Radiographic Evidence ◽  
Non Invasive ◽  
Consensus Recommendations ◽  
Portosystemic Collateral ◽  
Collateral Vessels

scholarly journals Risk Factors for Esophageal Collateral Veins in Cirrhosis with and without Previous Endoscopic Esophageal Variceal Therapy

2022 ◽  
Vol 2022 ◽  
pp. 1-13
Author(s):  
Qianqian Li ◽  
Xiaozhong Guo ◽  
Ji Feng ◽  
Xiangbo Xu ◽  
Saurabh Chawla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Injection Sclerotherapy ◽  
Gastroesophageal Varices ◽  
Subgroup Analyses ◽  
Portosystemic Collateral ◽  
Independent Risk Factors ◽  
Collateral Vessels

Background. Portosystemic collateral vessels are a sign of portal hypertension in liver cirrhosis. Esophageal collateral veins (ECVs) are one major type of portosystemic collateral vessels, which increase the recurrence of esophageal varices and bleeding after variceal eradication. However, the risk factors for ECVs were still unclear. Methods. We retrospectively screened cirrhotic patients who had contrast-enhanced computed tomography (CT) images to evaluate ECVs and upper gastrointestinal endoscopic reports to evaluate gastroesophageal varices at our department. Univariate and multivariate logistic regression analyses were performed to explore the independent risk factors for ECVs. Odds ratios (ORs) were calculated. Subgroup analyses were performed in patients with and without previous endoscopic variceal therapy which primarily included endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS). Results. Overall, 243 patients were included, in whom the prevalence of ECVs was 53.9%. The independent risk factors for ECVs were hepatitis C virus infection (OR = 0.250, p  = 0.026), previous EVL (OR = 1.929, p  = 0.044), platelet (OR = 0.993, p  = 0.008), and esophageal varices needing treatment (EVNTs) (OR = 2.422, p  = 0.006). The prevalence of ECVs was 60.8% (73/120) in patients undergoing EVL, 50% (10/20) in those undergoing EIS, and 47.5% (48/101) in those without previous endoscopic variceal therapy. The independent risk factors for ECVs were the use of nonselective beta-blockers (OR = 0.294, p  = 0.042) and EVNTs (OR = 3.714, p  = 0.006) in subgroup analyses of patients with and without previous endoscopic variceal therapy, respectively. Conclusions. The presence of ECVs should be closely associated with the severity of portal hypertension in liver cirrhosis. Risk of ECVs might be increased by previous EVL.

scholarly journals A72 NON-INVASIVE PREDICTION OF ESOPHAGEAL VARICES BY TRANSIENT ELASTOGRAPHY AND PLATELET COUNT IN PATIENTS WITH HEPATITIS B AND ADVANCED CHRONIC LIVER DISEASE: VALIDATION OF BAVENO VI AND EXPANDED BAVENO VI CRITERIA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-38
Author(s):  
A Zoughlami ◽  
J Serero ◽  
G Sebastiani ◽  
M Deschenes ◽  
P Wong ◽  
...  
Keyword(s):  
Platelet Count ◽  
Liver Disease ◽  
Hepatitis B ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Diagnostic Performance ◽  
Transient Elastography ◽  
Chronic Liver ◽  
Non Invasive ◽  
Chronic Hepatitis B Virus

Abstract Background Patients with compensated advanced chronic liver disease (cACLD) are at higher risk of developing complications from portal hypertension, including esophageal varices (EV). Baveno VI and expanded Baveno VI criteria, based on liver stiffness measurement (LSM) by transient elastography combined with platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for large esophageal varices needing treatment (EVNT). This approach has not been validated in patients with chronic hepatitis B virus (HBV) infection, who have etiology-specific cut-off of LSM for liver fibrosis. Aims We aimed to validate the Baveno VI and expanded Baveno VI criteria for EVNT in HBV patients with cACLD. Methods We performed a retrospective analysis of HBV patients who underwent LSM in 2014–2020. Inclusion criteria were: a) diagnosis of cACLD, defined as LSM >9 kPa; b) availability of EGD and platelets within 1 year of LSM. Baveno VI (LSM <20 kPa and platelets >150,000) and expanded Baveno VI criteria (LSM <25 kPa and platelets >110,000) were tested for EGD sparing. Diagnostic performance of these criteria against gold standard (EGD) was computed and compared to patients with hepatitis C virus (HCV) infection and nonalcoholic steatohepatitis (NASH) etiologies, where these criteria have been widely validated. In these patients, the threshold for cACLD definition was >10 kPa. Results A total of 287 patients (mean age 56, 95% Child A) were included, comprising of 43 HBV (58% on antiviral therapy), 134 HCV and 110 NASH patients. The prevalence of any grade EV and EVNT was 25% and 8% in the whole cohort, with 19% and 5% in HBV patients, respectively. Table 1 reports diagnostic performance, spared EGD and missed EVNT according to non-invasive criteria and cACLD etiology. Both Baveno VI and expanded Baveno VI criteria performed well in patients with HBV-related cACLD. There was no significant difference on diagnostic performance of these non-invasive criteria across the cACLD etiologies. Conclusions These results support use of non-invasive criteria based on LSM and platelets to spare unnecessary EGD in patients with HBV and cACLD. Baveno VI and expanded Baveno VI criteria can improve resource utilization and avoid invasive testing in context of screening EGD for patients with HBV-related cACLD. Funding Agencies None

Non-invasive response prediction in prophylactic carvedilol therapy for cirrhotic patients with esophageal varices

2019 ◽  
Vol 70 (3) ◽  
pp. 412-422 ◽  
Author(s):  
Hwi Young Kim ◽  
Young Ho So ◽  
Won Kim ◽  
Dong-Won Ahn ◽  
Yong Jin Jung ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Response Prediction ◽  
Non Invasive ◽  
Cirrhotic Patients

scholarly journals Immature Platelet Fraction as a Non-Invasive Marker for Esophageal Varices

2021 ◽  
pp. 55-64
Author(s):  
Alyaa Marzouk Soliman ◽  
Sherief Mohamed Abd-Elsalam ◽  
Amal Saeid ALBendary ◽  
Osama El. Sayed Negm
Keyword(s):  
Esophageal Varices ◽  
Significant Positive Correlation ◽  
Oesophageal Varices ◽  
P Value ◽  
Positive Correlation ◽  
Non Invasive ◽  
Immature Platelet Fraction ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
Group 1

Background: All cirrhotic patients should be screened for oesophageal varices (OV) at the time of diagnosis. The development of a non-invasive method for the detection of OV is a vital issue in subjects with cirrhosis to decrease the need for invasive endoscopic procedures that can be costly. This work aimed to evaluate immature platelet fraction (IPF) as a non-invasive marker and predictor of OV. Methods: This cross-sectional study was carried out on 80 cirrhotic patients with esophageal varices diagnosed by upper endoscopy. They were divided into Group (1): 40 patients with cirrhosis with esophageal varices and Group (2): 40 patients with cirrhosis and without esophageal varices. All patients were subjected to the complete history taking, physical examination, routine laboratory investigations (Complete blood count, IPF, C-reactive protein, Liver and kidney function tests, Bone marrow aspiration for some cases, Ascetic sample analysis when applicable), Pelvic-Abdominal ultrasonography, Child Pugh score assessment, Upper GIT endoscopy. Results: There was a significant difference between the studied groups regarding IPF (p<0.001). At cutoff >12 IPF had (AUC= 0.993) with sensitivity of 97.5% and specificity of 97.5% for detection of esophageal varices. There was a significant negative correlation between IPF and platelets count (p- value < 0.001). There was a significant positive correlation between IPF and Child Pugh score (p- value <0.001). There was a highly significant positive correlation between IPF and CRP (p value <0.001). There was significant difference between the two groups as regards splenic longitudinal diameter (p<0.001). As regards platelet count, there was a significant difference between the two groups (p<0.001). It was significantly lower in Group 1. Conclusions: IPF is elevated in cirrhotic patients with naive esophageal varices than in cirrhotic patients without varices. IPF could be used as a noninvasive, easy to measure method for detection of the presence of esophageal varices at a cutoff level of >12.

P.04.3 SPLEEN AND LIVER ELASTOGRAPHY AS A NON-INVASIVE TOOL FOR DETECTION OF ESOPHAGEAL VARICES IN PATIENTS WITH LIVER CIRRHOSIS

2019 ◽  
Vol 51 ◽  
pp. e172 ◽  
Author(s):  
D. Macor ◽  
M. Giuffrè ◽  
F. Tinè ◽  
F. Masutti ◽  
C. Abazia ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Non Invasive ◽  
Liver Elastography

scholarly journals The indocyanine green retention test as a non-invasive marker for esophageal varices in patients with hepatocellular carcinoma

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hsiao-Sheng Lu ◽  
I-Fang Hsin ◽  
Ping-Hsien Chen ◽  
Tsung-Chieh Yang ◽  
Chung-Yu Chang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Indocyanine Green ◽  
Esophageal Varices ◽  
Retention Test ◽  
Non Invasive

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

Sign in / Sign up

Export Citation Format

Share Document