{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:16:05Z","timestamp":1788430565406,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The role of endoscopic ultrasonography (EUS) in surveillance after endoscopic variceal ligation (EVL) for primary prophylaxis of esophageal variceal hemorrhage remains uncertain. This study compared the predictive value of high-frequency intraluminal ultrasound (HFIUS) and esophagogastroduodenoscopy (EGD) for subsequent variceal hemorrhage after prophylactic EVL. Methods: In this retrospective study, follow-up EGD and HFIUS were performed in 40 patients with liver cirrhosis who underwent EVL as primary prophylaxis against variceal hemorrhage. EGD-based variceal grade and variceal cross-sectional area (CSA) measured by HFIUS were compared in all 40 patients. Among them, 31 who achieved variceal eradication or reduction to grade 0\/1 on surveillance EGD were subsequently followed to evaluate subsequent variceal hemorrhage and clinical outcomes. Results: Spearman\u2019s correlation analysis revealed a statistically significant yet weak positive correlation between EGD-based variceal grade and variceal CSA measured by HFIUS (\u03c1 = 0.347, p = 0.028). Among the 31 patients with grade 0\/1 varices on follow-up EGD, the mean follow-up duration was 32.4 \u00b1 8.8 months, during which variceal hemorrhage occurred in seven patients and five patients died. In this exploratory analysis based on seven hemorrhagic events, a preliminary variceal CSA cutoff of 9.8 mm2 predicted subsequent hemorrhage with an apparent sensitivity of 85.7% and specificity of 91.7% (optimism-corrected 75.3% and 90.0%; bootstrap-corrected AUC 0.945). Multivariate analysis showed that variceal CSA measured by HFIUS was independently associated with variceal hemorrhage (OR, 1.302; 95% CI, 1.040\u20132.020; p = 0.016), whereas EV grade assessed by surveillance EGD was not predictive of variceal hemorrhage. Conclusions: HFIUS-derived variceal CSA was associated with subsequent hemorrhage among patients with grade 0\/1 varices after EVL and may provide prognostic information not captured by endoscopic grade alone. Incorporation of HFIUS-based EUS into post-EVL surveillance may help identify patients at persistent bleeding risk who may benefit from intensified prophylactic strategies, even when grade 0\/1 eradication has been confirmed on surveillance EGD. Given the small number of events, the proposed cutoff is preliminary and requires external validation.<\/jats:p>","DOI":"10.3390\/diagnostics16172836","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:20:43Z","timestamp":1788427243000},"page":"2836","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Frequency Intraluminal Ultrasound Versus Esophagogastroduodenoscopy for Predicting Variceal Hemorrhage After Prophylactic Endoscopic Variceal Ligation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8449-034X","authenticated-orcid":false,"given":"Hana","family":"Park","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Jeong Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of 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Han","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Young Koog","family":"Cheon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Tae Yoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Sang Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6777-4491","authenticated-orcid":false,"given":"Se Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1166-0085","authenticated-orcid":false,"given":"Joo Hye","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul 05030, Republic of Korea"},{"name":"Digestive Disease Center, Konkuk University Hospital, Seoul 05030, Republic of 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