Pulsatile Wave in Esophageal Wall Blood Vessels after Endoscopic Therapy for Esophageal Varices

Abstract: This study was designed to evaluate the clinical significance of the pulsatile wave in esophageal wall blood vessels after endoscopic therapy using endoscopic color Doppler ultrasonography (ECDUS) in 53 patients with esophageal varices. Ten of the 53 had recurrent intramucosal venous dilatation (F₀ type) of the esophagus, four of F₃ type and 39 of F₂ type. The endoscopic therapy techniques used in this study included endoscopic injection sclerotherapy (EIS) and heat-probe coagulation treatment (HPT) in 23 cases, endoscopic variceal ligation (EVL), EIS and HPT in 14, EVL and HPT in six, and HPT only in ten. The pulsatile wave in esophageal wall blood vessels was delineated in 10 of 53 (18.9%) patients using ECDUS after endoscopic therapy. Herein, we describe the ECDUS findings of pulsatile wave-positive cases. The esophageal wall was thickened yielding a low echoic pattern, and the pulsatile wave in blood vessels was delineated by color flow from the extra to the intra-esophageal wall in all patients. We calculated the maximum velocity (V_max), minimum velocity (V_min) and pulsatility index (PI). V_max of the pulsatile wave in blood vessels was found to be 9.7–24.0cm/sec (16.9±4.8cm/sec), V_min 3.0–14.3cm/sec (5.6±3.4cm/sec), and PI 0.81–1.72 (1.33±0.28). We also investigated the prognosis of pulsatile wave-positive patients. Esophageal varices recurred in two of the 10 cases. The PI of these cases were 0.81 and 0.98. There was no recurrence of esophageal varices in cases with PI values over 1.0.