PTFE Covered Stents Versus Naked Stents in the TIPS (Transjugular Intra-hepatic Porto-systemic Shunt)

NCT ID: NCT00593528

Last Updated: 2025-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

138 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-18

Study Completion Date

2011-07-11

Brief Summary

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Transjugular intrahepatic portosystemic shunts (TIPS) have been increasingly used for the treatment of complications of portal hypertension in patients with cirrhosis.

The initial experiment of the TIPS was reported during the 1990s with stents of various brands, manufacture and sizes, but all "non covered", thus owing the pseudointimal hyperplasia growing inside the stent, which progressively decreases the diameter of the shunt and thus its efficacy. Since the beginning of the 2000s, appeared stents known as "covered" by polytetrafluoroethylene (PTFE) designed to reduce the obstruction rate and thus the frequency shunt revisions. However, these stents are, on average, 2.5 times more expensive than the non covered stents and the cost-effectiveness ratio of the TIPS according to the type of stents used has not been assessed.

The aim of this multicentric and randomized study is to assess the cost-effectiveness ratio of these 2 principles of TIPS, the one using stents covered by PTFE, relatively expensive but seldom becoming obstructed, and the other using non covered stents, less expensive than PTFE but requiring regular gestures of redilatation.

Population concerned: Patients with a cirrhotic portal hypertension responsible for:

* recurrent variceal bleeding
* refractory ascite (or hydrothorax)

Detailed Description

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Conditions

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Cirrhotic Portal Hypertension

Keywords

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Cirrhosis, STIC TIPS, Portal Hypertension, Transjugular Intrahepatic Portosystemic Shunt , Stents, PTFE cirrhotic HTP

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A

Naked Stents

Group Type ACTIVE_COMPARATOR

Naked Stents: Wallstent® (Boston Scientific), Luminexx® (Bard), Zilver® (Cook), Palmaz Genesis® and Smart Control® (Cordis)

Intervention Type DEVICE

Vascular Stents

Transjugular intrahepatic portosystemic shunt (TIPS)

Intervention Type PROCEDURE

Transjugular intrahepatic portosystemic shunt (TIPS)

B

PTFE Covered Stents

Group Type EXPERIMENTAL

PTFE Covered Stents: Fluency® (Bard), Advanta V12® (Atrium) and Viatorr® (Gore)

Intervention Type DEVICE

Vascular Stents

Transjugular intrahepatic portosystemic shunt (TIPS)

Intervention Type PROCEDURE

Transjugular intrahepatic portosystemic shunt (TIPS)

Interventions

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Naked Stents: Wallstent® (Boston Scientific), Luminexx® (Bard), Zilver® (Cook), Palmaz Genesis® and Smart Control® (Cordis)

Vascular Stents

Intervention Type DEVICE

PTFE Covered Stents: Fluency® (Bard), Advanta V12® (Atrium) and Viatorr® (Gore)

Vascular Stents

Intervention Type DEVICE

Transjugular intrahepatic portosystemic shunt (TIPS)

Transjugular intrahepatic portosystemic shunt (TIPS)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Presence of a cirrhosis as documented by previous liverbiopsy or typical clinical signs
* Indication validated of the TIPS (Bavéno IV), except not-controlled acute hemorrhagic :

* Recurrent variceal bleeding after failure of the usual pharmacological and endoscopic methods
* Refractory or recurrent ascites or difficult to treat
* Refractory Hydrothorax

Exclusion Criteria

* Non cirrhotic HTP
* CHILD C ≥12
* Complete portal vein thrombosis
* Usual contra-indication for TIPS :

* Known or suspected Hepatocarcinoma by increase of the alpha-foetoprotein \>100 UI/mL associated with the presence of at least one hepatic nodule
* Cardiac insufficiency defined by a ventricular fraction of ejection \< 40% with the echocardiography preliminary to the procedure
* Pulmonary arterial hypertension (PAP \> 40 mmHg)
* Hepatic polycystosis
* Intra-hepatic bile ducts dilatation,
* Spontaneous clinical recurrent hepatic encephalopathy
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Tours

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Marc PERARNAU, Doctor

Role: PRINCIPAL_INVESTIGATOR

CHRU TOURS

Locations

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Chru Bordeaux

Bordeaux, , France

Site Status

Chru Caen

Caen, , France

Site Status

Chru Clermont Ferrand

Clermont-Ferrand, , France

Site Status

Chru Dijon

Dijon, , France

Site Status

AP-HM / La Conception

Marseille, , France

Site Status

AP-HM / La Timone

Marseille, , France

Site Status

CHRU NANTES / Hôtel-Dieu

Nantes, , France

Site Status

CHRU NANTES / Hôpital Guillaume et René Laënnec

Nantes, , France

Site Status

Chru Nice

Nice, , France

Site Status

Chru Poitiers

Poitiers, , France

Site Status

CHRU de TOURS

Tours, , France

Site Status

Ap-Hp (Paul Brousse)

Villejuif, , France

Site Status

Countries

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France

References

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Tripathi D, Redhead D. Transjugular intrahepatic portosystemic stent-shunt: technical factors and new developments. Eur J Gastroenterol Hepatol. 2006 Nov;18(11):1127-33. doi: 10.1097/01.meg.0000236871.78280.a7.

Reference Type BACKGROUND
PMID: 17033430 (View on PubMed)

Riggio O, Angeloni S, Nicolao F, Ridola L, Salvatori FM et al. Hepatic Encephalopathy is more frequent and severe after Transjugular intrahepatic portosystemeic Shunt (TIPS) with PTFE-coveted stent-grafts. Hepatology 2006;44, suppl 1, 232

Reference Type BACKGROUND

Perarnau JM, Noeldge G, Rossle M. [Intrahepatic portacaval anastomosis by the transjugular approach. Use of the Palmaz endoprosthesis]. Presse Med. 1991 Nov 9;20(36):1770-2. French.

Reference Type BACKGROUND
PMID: 1836597 (View on PubMed)

Bureau C, Garcia-Pagan JC, Otal P, Pomier-Layrargues G, Chabbert V, Cortez C, Perreault P, Peron JM, Abraldes JG, Bouchard L, Bilbao JI, Bosch J, Rousseau H, Vinel JP. Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study. Gastroenterology. 2004 Feb;126(2):469-75. doi: 10.1053/j.gastro.2003.11.016.

Reference Type BACKGROUND
PMID: 14762784 (View on PubMed)

Nishimine K, Saxon RR, Kichikawa K, Mendel-Hartvig J, Timmermans HA, Shim HJ, Uchida BT, Barton RE, Keller FS, Rosch J. Improved transjugular intrahepatic portosystemic shunt patency with PTFE-covered stent-grafts: experimental results in swine. Radiology. 1995 Aug;196(2):341-7. doi: 10.1148/radiology.196.2.7617843.

Reference Type BACKGROUND
PMID: 7617843 (View on PubMed)

Angermayr B, Cejna M, Koenig F, Karnel F, Hackl F, Gangl A, Peck-Radosavljevic M; Vienna TIPS Study Group. Survival in patients undergoing transjugular intrahepatic portosystemic shunt: ePTFE-covered stentgrafts versus bare stents. Hepatology. 2003 Oct;38(4):1043-50. doi: 10.1053/jhep.2003.50423.

Reference Type BACKGROUND
PMID: 14512892 (View on PubMed)

Charon JP, Alaeddin FH, Pimpalwar SA, Fay DM, Olliff SP, Jackson RW, Edwards RD, Robertson IR, Rose JD, Moss JG. Results of a retrospective multicenter trial of the Viatorr expanded polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt creation. J Vasc Interv Radiol. 2004 Nov;15(11):1219-30. doi: 10.1097/01.RVI.0000137434.19522.E5.

Reference Type BACKGROUND
PMID: 15525740 (View on PubMed)

Barrio J, Ripoll C, Banares R, Echenagusia A, Catalina MV, Camunez F, Simo G, Santos L. Comparison of transjugular intrahepatic portosystemic shunt dysfunction in PTFE-covered stent-grafts versus bare stents. Eur J Radiol. 2005 Jul;55(1):120-4. doi: 10.1016/j.ejrad.2004.10.007.

Reference Type BACKGROUND
PMID: 15950109 (View on PubMed)

Vignali C, Bargellini I, Grosso M, Passalacqua G, Maglione F, Pedrazzini F, Filauri P, Niola R, Cioni R, Petruzzi P. TIPS with expanded polytetrafluoroethylene-covered stent: results of an Italian multicenter study. AJR Am J Roentgenol. 2005 Aug;185(2):472-80. doi: 10.2214/ajr.185.2.01850472.

Reference Type BACKGROUND
PMID: 16037523 (View on PubMed)

Rossle M, Siegerstetter V, Euringer W, Olschewski M, Kromeier J, Kurz K, Langer M. The use of a polytetrafluoroethylene-covered stent graft for transjugular intrahepatic portosystemic shunt (TIPS): Long-term follow-up of 100 patients. Acta Radiol. 2006 Sep;47(7):660-6. doi: 10.1080/02841850600806324.

Reference Type BACKGROUND
PMID: 16950701 (View on PubMed)

Gandini R, Konda D, Simonetti G. Transjugular intrahepatic portosystemic shunt patency and clinical outcome in patients with Budd-Chiari syndrome: covered versus uncovered stents. Radiology. 2006 Oct;241(1):298-305. doi: 10.1148/radiol.2411050347. Epub 2006 Aug 14.

Reference Type BACKGROUND
PMID: 16908675 (View on PubMed)

Perarnau JM, Le Gouge A, Nicolas C, d'Alteroche L, Borentain P, Saliba F, Minello A, Anty R, Chagneau-Derrode C, Bernard PH, Abergel A, Ollivier-Hourmand I, Gournay J, Ayoub J, Gaborit C, Rusch E, Giraudeau B; STIC-TIPS group. Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial. J Hepatol. 2014 May;60(5):962-8. doi: 10.1016/j.jhep.2014.01.015. Epub 2014 Jan 27.

Reference Type RESULT
PMID: 24480619 (View on PubMed)

Other Identifiers

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STIC07-JMP/TIPS-PTFE

Identifier Type: -

Identifier Source: org_study_id

2007-A00857-46

Identifier Type: OTHER

Identifier Source: secondary_id