[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100644097":3},{"organization":4,"armGroups":7,"interventions":14,"overallOfficials":19,"centralContacts":20,"locations":26,"responsibleParty":43,"collaborators":19,"id":48,"slug":49,"hasResults":50,"nctId":51,"briefTitle":52,"officialTitle":53,"acronym":19,"eligibilityCriteria":54,"healthyVolunteers":50,"sex":55,"minAge":56,"maxAge":57,"enrollmentInfo":58,"targetDuration":19,"studyType":61,"phases":62,"briefSummary":64,"conditions":65,"keywords":69,"overallStatus":74,"whyStopped":19,"lastUpdateSubmitDate":75,"lastUpdatePostDateStruct":76,"startDateStruct":79,"completionDateStruct":81,"leadSponsor":83,"locationsCount":84},{"fullName":5,"class":6},"Air Force Military Medical University, China","OTHER",[8],{"label":9,"type":10,"description":11,"interventionNames":12},"Percutaneous mesenteric vein-assisted interventional treatment","EXPERIMENTAL","Eligible patients include those with imaging-confirmed OPVT and recurrent gastroesophageal variceal bleeding, particularly when conventional interventional access routes (e.g., transjugular-only approaches, percutaneous transhepatic access, or transsplenic access) are limited, infeasible, or have failed. Under real-time ultrasound guidance, percutaneous mesenteric vein (MV) access is obtained to establish an antegrade working channel, which is then used to facilitate portal vein recanalization and\u002For shunt creation.",[13],"Procedure: Percutaneous mesenteric vein-assisted interventional treatment",[15],{"type":16,"name":9,"description":17,"armGroupLabels":18,"otherNames":19},"PROCEDURE","Intervention (stepwise intra-procedural strategy). After MV access is established under ultrasound guidance, operators will follow a predefined escalation algorithm based on anatomy and feasibility:\n\nMV-assisted PVR-TIPS (preferred): Using antegrade catheter\u002Fguidewire manipulation via MV access, attempt recanalization of the occluded main portal vein trunk. A catheter or balloon may be positioned as a target to complete standard TIPS via the transjugular route.\n\nMV-assisted collateral-to-caval shunt (secondary): If main portal vein recanalization is not achievable, catheterize an eligible collateral (e.g., ≥6 mm) and, with target-marker assistance, create a collateral-to-inferior vena cava shunt via the transjugular route.\n\nExtrahepatic MV-to-caval shunt (backup): If neither main portal vein recanalization nor a suitable collateral is available, create an extrahepatic MV-to-inferior vena cava shunt tract through MV access as an alternative portal decompression strategy.",[9],null,[21],{"name":22,"role":23,"phone":24,"phoneExt":19,"email":25},"Jun Tie","CONTACT","+862984771537","tiejun7776@163.com",[27],{"facility":28,"status":19,"city":29,"state":30,"zip":31,"country":32,"countryCode":33,"cosmosGeoPoint":34,"geoPoint":39,"contacts":40},"Air Force Medical University","Xi'an","Shaanxi","710032","China","CN",{"type":35,"coordinates":36},"Point",[37,38],108.92861,34.25833,{"lat":38,"lon":37},[41],{"name":42,"role":23,"phone":24,"phoneExt":19,"email":25},"Jun Tie, M.D.,Ph.D.",{"type":44,"investigatorFullName":45,"investigatorTitle":46,"investigatorAffiliation":47,"oldNameTitle":19,"oldOrganization":19},"PRINCIPAL_INVESTIGATOR","Tie Jun","Director of clinical research","The First Affiliated Hospital of Air Force Medicial University","100644097","mesenteric-vein-access-for-opvt-related-recurrent-variceal-bleeding-an-ambispective-cohort-100644097",false,"NCT07666256","Mesenteric Vein Access for OPVT-Related Recurrent Variceal Bleeding: An Ambispective Cohort","Percutaneous Mesenteric Vein Access for Interventional Management of Recurrent Variceal Bleeding in Occlusive Portal Vein Thrombosis: An Ambispective Cohort Study","Inclusion Criteria\n\n1. Confirmed OPVT, as demonstrated by contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI).\n2. History of at least two episodes of esophagogastric variceal bleeding.\n3. Ineligible for, or have previously failed, conventional transjugular intrahepatic portosystemic shunt (TIPS) or percutaneous transhepatic\u002Ftranssplenic access approaches, including but not limited to extensive thrombosis of intrahepatic portal vein branches, prior splenectomy, or previous unsuccessful attempts.\n4. Child-Pugh score ≤12, with anticipated tolerance of the interventional procedure.\n\nExclusion Criteria\n\n1. Thrombosis or severe stenosis of the superior mesenteric vein (SMV), precluding its use as a percutaneous access route.\n2. Severe cardiac, pulmonary, or renal insufficiency that precludes tolerance of the procedure.\n3. Uncorrectable coagulopathy.\n4. Life expectancy \\\u003C3 months, or inability to comply with scheduled follow-up visits.","ALL","18 Years","75 Years",{"count":59,"type":60},15,"ESTIMATED","INTERVENTIONAL",[63],"NA","Occlusive portal vein thrombosis (OPVT) is defined as complete thrombosis of the main portal vein trunk, resulting in total interruption of portal venous inflow and representing the most severe form of portal vein thrombosis. A small proportion of patients may remain asymptomatic for prolonged periods because of sufficient collateral compensation; however, most develop complications of portal hypertension when collateral flow is inadequate, including gastroesophageal variceal bleeding and ascites. Among these, gastroesophageal variceal bleeding is the most life-threatening, and its management is more challenging-with a higher risk of rebleeding-than in patients without portal vein thrombosis.\n\nOcclusive portal vein thrombosis (OPVT) is defined as complete thrombosis of the main portal vein trunk, resulting in total interruption of portal venous inflow and representing the most severe form of portal vein thrombosis. A small proportion of patients may remain asymptomatic for prolonged periods because of sufficient collateral compensation; however, most develop complications of portal hypertension when collateral flow is inadequate, including gastroesophageal variceal bleeding and ascites. Among these, gastroesophageal variceal bleeding is the most life-threatening, and its management is more challenging-with a higher risk of rebleeding-than in patients without portal vein thrombosis.\n\nTransjugular intrahepatic portosystemic shunt (TIPS) is an effective minimally invasive therapy for portal hypertension-related complications; however, in OPVT, technical feasibility largely depends on successful portal vein recanalization. To improve TIPS success in OPVT, our group-together with domestic and international investigators-has explored several adjunctive access routes and technical modifications, including percutaneous transhepatic or transsplenic portal vein recanalization TIPS (PVR-TIPS); transjugular portal cavernous collateral-caval shunt (TCCS); transjugular mesenteric-caval shunt (TMCS); transjugular spleno-caval shunt (TSCS); and surgically assisted hybrid procedures. Although these strategies have improved technical success rates to some extent, their applicability remains limited. In patients with extensive thrombosis involving intrahepatic portal vein branches, in those without a feasible splenic venous puncture route, or in patients with prior splenectomy, percutaneous transhepatic and transsplenic approaches are often not possible. Moreover, in patients with poor hepatic reserve and\u002For ascites, laparotomy-assisted hybrid procedures substantially increase invasiveness and perioperative risk.\n\nIn this context, the present project aims to systematically investigate and evaluate ultrasound-guided percutaneous mesenteric vein (MV) puncture as an adjunctive access strategy for interventional treatment of OPVT. This technique uses ultrasound-guided percutaneous puncture of the MV to establish antegrade portal venous access, thereby facilitating subsequent portal vein recanalization and\u002For shunt creation.",[66,67,68],"Occlusive Portal Vein Thrombosis (OPVT)","Cavernous Transformation of Portal Vein","Gastroesophageal Varices Bleeding",[70,67,71,72,73],"Occlusive portal vein thrombosis (OPVT)","Esophageal and gastric variceal bleeding","Transjugular intrahepatic portosystemic shunt","Superior Mesenteric Vein","NOT_YET_RECRUITING","2026-06-18",{"date":77,"type":78},"2026-06-24","ACTUAL",{"date":80,"type":60},"2026-07-01",{"date":82,"type":60},"2028-06-30",{"name":5,"class":6},1]