Before endoscopy, all patients were subjected to clinical assessment including history taking and physical examination, routine laboratory investigations including complete blood count, liver function profile and serum creatinine, and assessment of the severity of underlying disease by Child-Turcotte-Pugh (CTP) score and Model for End-Stage Liver Disease (MELD) score. All procedures were performed under deep sedation or general anesthesia in the left lateral position. Standard diagnostic upper endoscopy was performed with Pentax EG2990i (PENTAX medical, Tokyo, Japan) to classify the varices according to the classification of Sarin and Kumar. EUS examination was done in all patients with a Pentax linear Echoendoscope EG3870UTK (PENTAX medical, Tokyo, Japan) attached to a Hitachi Avius ultrasound system (Hitachi Medical Systems, Tokyo, Japan). All EUS examinations were done by single endosonographer. The echoendoscope was positioned in the distal esophagus at the level of the cardia to visualize the gastric fundus and to display the vascular anatomy including the size of the varix, color Doppler flow inside the varix and identification of the perforator feeding vein (one or more vein crossing the gastric wall to feed the GV from the peri-gastric veins).