| [ Summary ] |
For the safe and effective treatment of esophageal varices, lesions were hemodynamically classified based on anatomical analysis of the collateral circulation, using multi-detector-row computed tomography (MD-CT). Forty-nine patients with esophageal varices having blood supplies from the left gastric vein (LGV) served as subjects of this study. The hemodynamics of the para-esophageal vein (PEV) were classified into the following three types: type I, those without PEV; type II, PEV which had developed a diameter equal to or less than the diameter of esophageal varices；and type III, cases where PEV exhibits greater diameters. For treatment, embolization must be extended to the root of the LGV in type I and in type II and III, embolization must be performed up to the point where LGV branches are observed. From the standpoint of hemodynamics classification type I is well suited for EIS and type II and type III, respond to both EIS and EVL treatment. Hemodynamic classification based on PEV using MD-CT is highly useful in formulating safe and effective therapeutic strategies. |