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8mm-TIPS Versus Endoscopic Variceal Ligation (EVL) Plus Propranolol for Prevention of Variceal Rebleeding in Patients With Child A Cirrhosis

Primary Purpose

Portal Hypertension

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
8mm-TIPS
endoscopic variceal ligation (EVL)
Propranolol
Sponsored by
West China Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Portal Hypertension

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Cirrhosis Patients who had bled from esophageal varices (≥5days and ≤28days) Child-Pugh A -

Exclusion Criteria:

The presence of gastric varices Non-cirrhotic portal hypertension Portal vein thrombosis The history of hepatic encephalopathy Total bilirubin ≥51.3 umol/L Previous treatment of TIPS or surgery Proven malignancy including hepatocellular carcinoma Contraindications to TIPS、EVL or propranolol End-stage renal disease under renal replacement therapy; Cardiorespiratory failure Pregnancy or patients not giving informed consent for endoscopic procedure

-

Sites / Locations

  • West china hospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

8mm-TIPS

EVL plus propranolol

Arm Description

Patients in this group would underwent TIPS placement with 8mm-diameter ePTFE-covered stents.

Patients in this group would underwent sequential endoscopic variceal ligation and propranolol treatment.

Outcomes

Primary Outcome Measures

Variceal rebleeding rate
Analysis

Secondary Outcome Measures

Hepatic encephalopathy rate
Analysis
TIPS dysfunction rate
Analysis
The incidence of complications
Analysis
Mortality rate
Analysis

Full Information

First Posted
March 23, 2017
Last Updated
November 20, 2021
Sponsor
West China Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03094234
Brief Title
8mm-TIPS Versus Endoscopic Variceal Ligation (EVL) Plus Propranolol for Prevention of Variceal Rebleeding in Patients With Child A Cirrhosis
Official Title
8mm-TIPS Versus Endoscopic Variceal Ligation (EVL) Plus Propranolol for Prevention of Variceal Rebleeding in Patients With Child A Cirrhosis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Recruiting
Study Start Date
April 28, 2017 (Actual)
Primary Completion Date
March 28, 2022 (Anticipated)
Study Completion Date
March 28, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
West China Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this study was to conduct a prospective randomized trial to compare TIPS with 8mm expanded polytetrafluoroethylene(ePTFE)-covered stents and endoscopic variceal ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding in patients with Child A cirrhosis
Detailed Description
For the prevention of recurrent esophageal variceal bleeding, previous clinical studies and meta-analysis show that patients treated with transjugular intrahepatic portosystemic shunt (TIPS) have lower rebleeding rates compared with endoscopic therapy. However, TIPS is associated with higher rates of portosystemic encephalopathy and does not show survival benefit. TIPS with a small-diameter may achieve sufficient portal decompression and reduce the incidence of hepatic encephalopathy. The aim of this study was to conduct a prospective randomized trial to compare TIPS with 8mm ePTFE-covered stents and endoscopic variceal ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Portal Hypertension

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Care Provider
Allocation
Randomized
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
8mm-TIPS
Arm Type
Active Comparator
Arm Description
Patients in this group would underwent TIPS placement with 8mm-diameter ePTFE-covered stents.
Arm Title
EVL plus propranolol
Arm Type
Active Comparator
Arm Description
Patients in this group would underwent sequential endoscopic variceal ligation and propranolol treatment.
Intervention Type
Device
Intervention Name(s)
8mm-TIPS
Intervention Description
Patients in this group would underwent TIPS placement with 8mm-diameter ePTFE-covered stents.
Intervention Type
Procedure
Intervention Name(s)
endoscopic variceal ligation (EVL)
Intervention Description
Patients in this group would underwent sequential endoscopic variceal ligation and propranolol treatment.
Intervention Type
Drug
Intervention Name(s)
Propranolol
Intervention Description
Appropriate dose of propranolol was administered to the patients.
Primary Outcome Measure Information:
Title
Variceal rebleeding rate
Description
Analysis
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Hepatic encephalopathy rate
Description
Analysis
Time Frame
3 years
Title
TIPS dysfunction rate
Description
Analysis
Time Frame
3 years
Title
The incidence of complications
Description
Analysis
Time Frame
3 years
Title
Mortality rate
Description
Analysis
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Cirrhosis Patients who had bled from esophageal varices (≥5days and ≤28days) Child-Pugh A - Exclusion Criteria: The presence of gastric varices Non-cirrhotic portal hypertension Portal vein thrombosis The history of hepatic encephalopathy Total bilirubin ≥51.3 umol/L Previous treatment of TIPS or surgery Proven malignancy including hepatocellular carcinoma Contraindications to TIPS、EVL or propranolol End-stage renal disease under renal replacement therapy; Cardiorespiratory failure Pregnancy or patients not giving informed consent for endoscopic procedure -
Facility Information:
Facility Name
West china hospital
City
Chengdu
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
xuefeng luo
Phone
02885422311
Email
luo_xuefeng@yeah.net

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
33089892
Citation
Simonetti RG, Perricone G, Robbins HL, Battula NR, Weickert MO, Sutton R, Khan S. Portosystemic shunts versus endoscopic intervention with or without medical treatment for prevention of rebleeding in people with cirrhosis. Cochrane Database Syst Rev. 2020 Oct 22;10(10):CD000553. doi: 10.1002/14651858.CD000553.pub3.
Results Reference
derived

Learn more about this trial

8mm-TIPS Versus Endoscopic Variceal Ligation (EVL) Plus Propranolol for Prevention of Variceal Rebleeding in Patients With Child A Cirrhosis

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