Table 1.
Patients’ baseline clinical characteristics (n = 45).
Fig 1.
Cumulative recurrence rates of esophageal varices (EV) after endoscopic treatment (ET).
During a median follow-up period of 30 months, recurrences of EV post-ET that required additional treatment occurred in 19 patients (42.2%), including seven patients with ruptured EV. After ET, the cumulative EV recurrence rates were 13.3% at 1 year, 29.5% at 2 years, and 32.2% at 3 years.
Table 2.
Univariate and multivariate analyses identifying factors that predict the recurrence of esophageal varices after endoscopic treatment.
Fig 2.
Cumulative recurrence rates of esophageal varices (EV) after endoscopic treatment (ET) according to the pretreatment Child-Pugh (CP) classification and/or a history of partial splenic embolization (PSE).
(A), The cumulative recurrence rates of EV in the CP class A patients were significantly lower than those in the CP class B or C patients (p < 0.05). (B), ET combined with PSE significantly reduced posttreatment variceal recurrence compared with ET alone (p < 0.01). (C), During follow-up, there were no recurrences of EV after ET combined with PSE in the CP class A patients, and ET alone without PSE in the CP class B or C patients was associated with a significantly highest incidence of variceal recurrence. CP-A, Child-Pugh class A; CP-B/C, Child-Pugh class B or C; PSE, partial splenic embolization.
Table 3.
Overall posttreatment recurrence rates of esophageal varices according to the timing of partial splenic embolization and the pretreatment Child-Pugh classification (n = 15).
Fig 3.
Hematological, hemodynamic, and hepatic functional changes in 15 patients who underwent partial splenic embolization (PSE) and endoscopic treatment.
(A), The mean platelet count increased significantly from 4.8 × 104/μL (standard deviation [SD] = 2.2) pre-PSE to 13.4 × 104/μL (SD = 8.7) at 1-month post-PSE (p < 0.01). Splenic artery embolization significantly reduced the (B) mean wedged hepatic venous pressure from 310.5 mmH2O (SD = 49.4) to 251.5 mmH2O (SD = 31.8) (p < 0.01), and the (C) mean hepatic venous pressure gradient from 214.5 mmH2O (SD = 55.5) to 152.0 mmH2O (SD = 44.0) (p < 0.01), which were measured before and immediately after PSE. (D) The mean Child-Pugh (CP) score decreased from 6.8 (SD = 1.7) pre-PSE to 6.3 (SD = 1.0) at 1-month post-PSE (p = 0.10); the changes in the CP classifications at 1-month post-PSE were as follows: CP class A to CP class A (n = 7), CP class B to CP class A (n = 3), CP class B to CP class B (n = 4), and CP class C to CP class B (n = 1). Plt, platelet; WHVP, wedged hepatic venous pressure; HVPG, hepatic venous pressure gradient; CP, Child-Pugh; PSE, partial splenic embolization; ET, endoscopic treatment; 1M, 1 month.