TIPS vs Endoscopic Therapy for Variceal Rebleeding in Cirrhotic Patients With Portal Vein Thrombosis

NCT ID: NCT02485184

Last Updated: 2022-10-25

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-09

Study Completion Date

2024-12-31

Brief Summary

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portal vein thrombosis may be a negative prognostic marker of variceal bleeding in liver cirrhosis. Compared with conventional endoscopic and pharmacological therapy, transjugular intrahepatic portosystemic shunt may further improve the outcomes of portal vein thrombosis in liver cirrhosis with variceal bleeding.

Detailed Description

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Portal vein thrombosis may be a negative prognostic marker of variceal bleeding in liver cirrhosis. Compared with conventional endoscopic and pharmacological therapy, transjugular intrahepatic portosystemic shunt may further improve the outcomes of portal vein thrombosis in liver cirrhosis with variceal bleeding. However, the safety of transjugular intrahepatic portosystemic shunt remains uncertain in patients with portal vein thrombosis.

Conditions

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Portal Vein Thrombosis Liver Cirrhosis

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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TIPS group

Transjugular intrahepatic portosystemic shunt

Group Type ACTIVE_COMPARATOR

Transjugular intrahepatic portosystemic shunt

Intervention Type PROCEDURE

Transjugular intrahepatic portosystemic shunt refers to an interventional radiological procedure by placing a stent between portal vein and hepatic vein. No specific device was used in the Interventional field.

ET & drugs groups

1. Endoscopic therapy.
2. Non-selective beta blockers.
3. Anticoagulation therapy.

Group Type ACTIVE_COMPARATOR

Non-selective beta blockers

Intervention Type DRUG

Non-selective beta blockers are the drugs for reducing the portal pressure.

Endoscopic therapy

Intervention Type PROCEDURE

Endoscopic therapy includes the endoscopic variceal band ligation

Anticoagulation

Intervention Type DRUG

Anticoagulation therapy includes heparin and warfarin.

Interventions

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Transjugular intrahepatic portosystemic shunt

Transjugular intrahepatic portosystemic shunt refers to an interventional radiological procedure by placing a stent between portal vein and hepatic vein. No specific device was used in the Interventional field.

Intervention Type PROCEDURE

Non-selective beta blockers

Non-selective beta blockers are the drugs for reducing the portal pressure.

Intervention Type DRUG

Endoscopic therapy

Endoscopic therapy includes the endoscopic variceal band ligation

Intervention Type PROCEDURE

Anticoagulation

Anticoagulation therapy includes heparin and warfarin.

Intervention Type DRUG

Other Intervention Names

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propranolol warfarin

Eligibility Criteria

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Inclusion Criteria

1. liver cirrhosis (histological or clinical);
2. Significant variceal bleeding \>5 days and ≤ 42 days
3. Successful treatment of the index bleed by means of vasoactive drugs and/or endoscopic treatment
4. Portal vein thrombosis occlusion\>=25% of the vessel lumen;
5. Presence of ascites
6. Child-Pugh score 8-12 at inclusion
7. Age 18 to 70 years

Exclusion Criteria

1. Bleeding from isolated gastric or ectopic varices
2. Contraindications to non-selective beta blockers (chronic obstructive pulmonary disease, asthma, aortic stenosis, atrioventricular block, intermittent claudication, and psychosis)
3. Contraindications to TIPS : extensive potral vein thrombosis, fibrotic cord replacing original main portal vein; bilirubin\>3.5 mg/dL, plasma creatinine\>2.1 mg/dL, Child-Pugh score \>=13points
4. A history of significant heart failure (New York Heart Association class III and IV)
5. Overt hepatic encephalopathy,
6. Prehepatic portal hypertension
7. Malignancy (including hepatocellular carcinoma) or a concomitant disease with reduced life expectancy
8. Uncontrolled infection and sepsis
9. Previous treatment to prevent rebleeding with a portosystemic shunt,TIPS or with pharmacological therapy with non-selective beta blockers and endoscopic variceal ligation
10. Pregnancy or lactation
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

OTHER

Sponsor Role collaborator

Shandong Provincial Hospital

OTHER_GOV

Sponsor Role collaborator

Third Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role collaborator

Southern Medical University, China

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Xinjiang Medical University

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Nanchang University

OTHER

Sponsor Role collaborator

Air Force Military Medical University, China

OTHER

Sponsor Role lead

Responsible Party

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Guohong Han

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Guohong Han, MD

Role: PRINCIPAL_INVESTIGATOR

Xi'an International Medical Center Hospital

Locations

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the First Affiliated Hospital, Air Force Medical University

Xi'an, Shaanxi, China

Site Status COMPLETED

Xi'an International Medical Center Hospital

Xi'an, Shaanxi, China

Site Status RECRUITING

Nanfang Hospital Affiliated to Southern Medical Univers

Guangzhou, , China

Site Status RECRUITING

The Third Affiliated Hospital of Sun Yat-sen University

Guangzhou, , China

Site Status RECRUITING

Provincial Hospital Affiliated to Shandong University

Jinan, , China

Site Status RECRUITING

The First Affiliated Hospital of Nanchang University

Nanchang, , China

Site Status RECRUITING

Affiliated Drum Tower Hospital of Nanjing University Medical School

Nanjing, , China

Site Status RECRUITING

The First Affiliated Hospital of Xinjiang Medical University

Ürümqi, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Guohong Han, MD

Role: CONTACT

86-13991969930

Yong Lv, MD

Role: CONTACT

Facility Contacts

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Guohong Han, MD,Ph.D

Role: primary

Jianbo Zhao, MD

Role: primary

Ming-an Li, MD

Role: primary

Chunqing Zhang, MD

Role: primary

Xuan Zhu, MD

Role: primary

Yuzheng Zhuge, MD

Role: primary

Weixin Ren, MD

Role: primary

References

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Han G, Qi X, He C, Yin Z, Wang J, Xia J, Yang Z, Bai M, Meng X, Niu J, Wu K, Fan D. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis. J Hepatol. 2011 Jan;54(1):78-88. doi: 10.1016/j.jhep.2010.06.029. Epub 2010 Aug 27.

Reference Type BACKGROUND
PMID: 20932597 (View on PubMed)

Lv Y, He C, Wang Z, Guo W, Wang J, Bai W, Zhang L, Wang Q, Liu H, Luo B, Niu J, Li K, Tie J, Yin Z, Fan D, Han G. Association of Nonmalignant Portal Vein Thrombosis and Outcomes after Transjugular Intrahepatic Portosystemic Shunt in Patients with Cirrhosis. Radiology. 2017 Dec;285(3):999-1010. doi: 10.1148/radiol.2017162266. Epub 2017 Jul 5.

Reference Type BACKGROUND
PMID: 28682164 (View on PubMed)

Other Identifiers

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PVT-TIPS2

Identifier Type: -

Identifier Source: org_study_id

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