EGD vs EUS in Diagnosing Portal Hypertension in Cirrhotic Patients.

NCT ID: NCT04191369

Last Updated: 2019-12-09

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

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-01

Study Completion Date

2020-11-30

Brief Summary

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Liver cirrhosis with the further development of portal hypertension implies structural and vasculature alteration in the portosplenic circulation.

Esophagogastroduodenoscopy is the standard of care for the detection and treatment of esophageal varices, as esophageal varices serve as a surrogate for estimating a portal pressure gradient \> 10 mmHG.

Endoscopic ultrasound evaluation allows the detection of peri-esophageal collateral veins, perforating veins and para-esophageal collateral veins, which has demonstrated to be effective for the prediction of esophageal varices recurrence after variceal eradication.

The investigators aimed to compare esophagogastroduodenoscopy versus endoscopic ultrasound evaluation for the early diagnosis of portal hypertension in cirrhotic patients.

Detailed Description

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A randomized control trial of 70 cirrhotic patients randomly submitted for esophagogastroduodenoscopy (35 patients) or EUS evaluation (35 patients) for the diagnosis of portal hypertension.

The portal pressure gradient will be defined based on portal vein catheterization via interventional radiology.

Esophagogastroduodenoscopy will evaluate the presence and grade of esophageal varices, presence and type of gastric varices, presence and signs of hypertensive gastropathy.

Endoscopic ultrasound will evaluate the presence of esophageal varices, the presence of gastric varices and the EUS- signs og hypertensive gastropathy, Azygos vein diameter, mean velocity and blood flow volume index.

Conditions

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Liver Cirrhoses Portal Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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EGD evaluation

Esophogagastroduodenoscopy for the evaluation of esophageal varices, gastric varices and hypertensive gastropathy. Portal pressure gradient will be evaluated via interventional radiology as gold standard.

Group Type PLACEBO_COMPARATOR

Esophagogastroduodenoscopy

Intervention Type DIAGNOSTIC_TEST

Esophogagastroduodenoscopy for the evaluation of esophageal varices, gastric varices and hypertensive gastropathy. Portal pressure gradient will be evaluated via interventional radiology as gold standard.

EUS evaluation

Endoscopic ultrasound evaluation for the presence of esophageal varices, peri and para-esophageal collateral veins, gastric varices, portal hypertensive gastropathy, azygos vein diameter, blood flow and BFVI.

Portal pressure gradient will be evaluated via interventional radiology as gold standard.

Group Type EXPERIMENTAL

Endoscopic ultrasound

Intervention Type DIAGNOSTIC_TEST

Endoscopic ultrasound evaluation for the presence of esophageal varices, peri and para-esophageal collateral veins, gastric varices, portal hypertensive gastropathy, azygos vein diameter, blood flow and BFVI.

Portal pressure gradient will be evaluated via interventional radiology as gold standard.

Interventions

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Esophagogastroduodenoscopy

Esophogagastroduodenoscopy for the evaluation of esophageal varices, gastric varices and hypertensive gastropathy. Portal pressure gradient will be evaluated via interventional radiology as gold standard.

Intervention Type DIAGNOSTIC_TEST

Endoscopic ultrasound

Endoscopic ultrasound evaluation for the presence of esophageal varices, peri and para-esophageal collateral veins, gastric varices, portal hypertensive gastropathy, azygos vein diameter, blood flow and BFVI.

Portal pressure gradient will be evaluated via interventional radiology as gold standard.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Above 18 years old
* Willingness to participate in the study
* Compensated liver cirrhosis based on clinical and imaging findings
* Written informed consent provided

Exclusion Criteria

* Decompensated liver cirrhosis: ascitis, encephalopathy, gastrointestinal bleeding, infection
* Hemodynamic instability
* Pregant or nursing patients
* Patients with history of esophageal, gastric, liver, pancreas and spleen tumors
* Severe uncontrolled coagulopathy
* Any contraindication for portal pressure gradient meassurement via radiological evaluation.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Ecuatoriano de Enfermedades Digestivas

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Ecuadorian Institute of Digestive Diseases

Guayaquil, Guayas, Ecuador

Site Status RECRUITING

Countries

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Ecuador

Facility Contacts

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Carlos A Robles-Medranda, MD

Role: primary

References

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Boustiere C, Dumas O, Jouffre C, Letard JC, Patouillard B, Etaix JP, Barthelemy C, Audigier JC. Endoscopic ultrasonography classification of gastric varices in patients with cirrhosis. Comparison with endoscopic findings. J Hepatol. 1993 Sep;19(2):268-72. doi: 10.1016/s0168-8278(05)80581-1.

Reference Type BACKGROUND
PMID: 8301060 (View on PubMed)

Hammoud GM, Ibdah JA. Utility of endoscopic ultrasound in patients with portal hypertension. World J Gastroenterol. 2014 Oct 21;20(39):14230-6. doi: 10.3748/wjg.v20.i39.14230.

Reference Type BACKGROUND
PMID: 25339809 (View on PubMed)

Other Identifiers

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EUS-EGD-PH

Identifier Type: -

Identifier Source: org_study_id