A Comprehensive Review of Portosystemic Collaterals in Cirrhosis: Historical Aspects, Anatomy, and Classifications

Figure 4

The Kiyosue classification of gastric varices. (a) Classification based on drainage pathway. Type A consists of a portosystemic shunt as the only drainage; Type B portosystemic shunts along with additional small portosystemic collaterals; in Type C, there is presence of multiple large portosystemic shunts; and Type D consists of multiple small portosystemic collaterals as the drainage pathways without proper shunt formation. (b) Classification based on the inflow pathway: Type 1 consists of single afferent vein for the varices; Type 2 has multiple afferent vessels contributing to the variceal formation; Type 3 is similar to Type 2 but with additional small collateral/shunts directly communicating with outflow tract. Modified and redrawn from [17].

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