Su1476 Efficacy of Combined Balloon-Occluded Retrograde Transvenous Obliteration With Ethanol and Endoscopic Injection Sclerotherapy for Gastric Varices

Abstract

excluded. Several clinical, biological, ultrasonographic, with Doppler study, and endoscopic data were collected and used to calculate the APRI score (AST to platelets ratio index) and congestion index (CI) of the portal vein (calculated by dividing portal vein cross-sectional area by portal blood velocity). All statistical analysis was performed with SPSS v. 18.0 and a p value of less than 0,05 was considered statistically significant. The performance of the scores was evaluated by the area under the receiver operating characteristic curve (AUROC). Results: 36 patients were included, 64% males, with mean age 60±8,6 years. On On endoscopy, 12 patients (33%) had no EV, 14 patients (39%) had small EV and 10 patients (28%) had large EV. Portal vein diameter was higher in patients with EV than those without EV, while platelet count and portal blood velocity were lower, however with no statistical difference, (p>0,05). APRI score and CI were good predictors for the presence of EV (AUROC 0.74 and 0,635 respectively). The combination of the APRI score for liver fibrosis and CI as a surrogate of portal hypertension resulted in an even more powerful predictor of the presence of EV (AUROC 0,797) and the best cutoff value was 0,075 (sensitivity 79,2%, specificity 75%, positive predictive value 86,4% and negative predictive value 64,3). Conclusions: APRI score and CI of the portal vein are good noninvasive tests to predict esophageal varices. The combination of both models is even more powerful to be used as a method to select cirrhotic patients who need to undergo upper GI endoscopy.