[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"gastroesophageal-varices-bleeding\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:gastroesophageal-varices-bleeding":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,4,0,[8,48,73,106],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":30,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":36,"lastUpdatePostDateStruct":37,"startDateStruct":40,"completionDateStruct":42,"leadSponsor":44,"locationsCount":47},"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":20,"type":21},15,"ESTIMATED","INTERVENTIONAL",[24],"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.",[27,28,29],"Occlusive Portal Vein Thrombosis (OPVT)","Cavernous Transformation of Portal Vein","Gastroesophageal Varices Bleeding",[31,28,32,33,34],"Occlusive portal vein thrombosis (OPVT)","Esophageal and gastric variceal bleeding","Transjugular intrahepatic portosystemic shunt","Superior Mesenteric Vein","NOT_YET_RECRUITING","2026-06-18",{"date":38,"type":39},"2026-06-24","ACTUAL",{"date":41,"type":21},"2026-07-01",{"date":43,"type":21},"2028-06-30",{"name":45,"class":46},"Air Force Military Medical University, China","OTHER",1,{"id":49,"slug":50,"hasResults":11,"nctId":51,"briefTitle":52,"officialTitle":53,"acronym":54,"eligibilityCriteria":55,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":56,"targetDuration":4,"studyType":22,"phases":58,"briefSummary":59,"conditions":60,"keywords":62,"overallStatus":64,"whyStopped":4,"lastUpdateSubmitDate":65,"lastUpdatePostDateStruct":66,"startDateStruct":68,"completionDateStruct":70,"leadSponsor":72,"locationsCount":47},"100612423","comparison-of-underdilated-versus-standard-tips-in-preventing-variceal-rebleeding-in-patients-with-cirrhosis-100612423","NCT07253389","Comparison of Underdilated Versus Standard TIPS in Preventing Variceal Rebleeding in Patients With Cirrhosis","Comparison of Underdilated Versus Standard Transjugular Intrahepatic Portosystemic Shunt in Preventing Rebleeding From Esophagogastric Varices in Patients With Cirrhosis in Chinese Tertiary Hospitals: Protocol for a Multicenter Randomized Controlled Trial","UVR-TIPS","Inclusion Criteria:\n\n1\\. Age 18-75 years. 2. Diagnosis of liver cirrhosis according to the 2023 Consensus Opinion on the Clinical Diagnosis and Treatment of Liver Cirrhosis in China (Chinese Society of Gastroenterology). Diagnosis is based on clinical manifestations and imaging findings; histological confirmation is required if the diagnosis remains inconclusive.\n\n3\\. High-risk acute variceal bleeding, defined as any of the following:\n\n1. High-risk acute esophageal or type 1 gastroesophageal variceal bleeding, including: Child-Pugh grade B with a score \\> 7 and endoscopic evidence of active bleeding; Child-Pugh grade C with a score \\\u003C 14.\n2. Hepatic venous pressure gradient (HVPG) \\> 20 mmHg during bleeding.\n3. Early rebleeding within 5 days.\n4. Bleeding uncontrolled despite pharmacological and endoscopic therapy. 4. History of esophageal or gastric variceal bleeding with failure of standard first-line treatment \\[endoscopy combined with non-selective beta-blockers (NSBB)\\]; or first hemorrhage accompanied by grade 2 ascites and\u002For portal vein thrombosis; GOV2 or IGV1 gastric variceal bleeding; ectopic variceal bleeding; or bleeding from refractory portal hypertensive gastropathy.\n\n5\\. Planned TIPS procedure. 6. Ability and willingness to provide written informed consent.\n\nExclusion Criteria:\n\n1. Budd-Chiari syndrome or other causes of non-cirrhotic portal hypertension.\n2. Current or prior malignancy, including hepatocellular carcinoma or malignancies of other organs.\n3. Complete thrombosis of the main portal vein.\n4. Severe psychiatric or neurologic disorders (e.g., uncontrolled epilepsy, dementia).\n5. Prior liver resection or liver transplantation.\n6. Prior TIPS or surgical portosystemic shunt.\n7. Pregnancy or lactation.\n8. Any contraindication to TIPS, including:\n\n(1) Congestive heart failure (New York Heart Association class C or D, or left ventricular ejection fraction \\\u003C 50%).\n\n(2) Severe pulmonary hypertension (mean pulmonary artery pressure \\> 45 mmHg as measured invasively).\n\n(3) Uncontrolled systemic infection. (4) Severe overt hepatic encephalopathy (OHE) with unmodifiable spontaneous portosystemic shunt.\n\n9.Acute hemorrhage with a MELD score ≥ 30 and\u002For arterial lactate \\> 12 mmol\u002FL, or presence of acute-on-chronic liver failure (ACLF).\n\n10\\. Systemic conditions requiring ongoing glucocorticoid or nonsteroidal anti-inflammatory drug (NSAID) therapy.",{"count":57,"type":21},648,[24],"Transjugular intrahepatic portosystemic shunt (TIPS) is a key therapeutic intervention for complications of portal hypertension. However, the risk of post-procedural hepatic encephalopathy (HE) limits its broader clinical application. In the management of gastroesophageal variceal bleeding, the primary goal of TIPS is to reduce the portosystemic pressure gradient (PPG) to less than 12 mmHg (16 cmH₂O), which defines the standard TIPS procedure. The investigators hypothesize that, in patients undergoing TIPS for the prevention of variceal rebleeding, stent underdilation using a 6-mm balloon (underdilated TIPS) will not increase the risk of rebleeding but may reduce the incidence of overt HE and attenuate liver injury. To test this hypothesis, the investigators have designed a prospective, multicenter, randomized controlled trial.",[61,29],"Liver Cirrhosis",[61,32,33,63],"Hepatic encephalopathy","RECRUITING","2026-06-06",{"date":67,"type":39},"2026-06-09",{"date":69,"type":39},"2025-10-20",{"date":71,"type":21},"2029-09-30",{"name":45,"class":46},{"id":74,"slug":75,"hasResults":11,"nctId":76,"briefTitle":77,"officialTitle":78,"acronym":79,"eligibilityCriteria":80,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":81,"targetDuration":4,"studyType":22,"phases":83,"briefSummary":84,"conditions":85,"keywords":89,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":96,"lastUpdatePostDateStruct":97,"startDateStruct":99,"completionDateStruct":101,"leadSponsor":103,"locationsCount":105},"100639849","underdilated-vcx-tips-versus-evl-plus-nsbb-for-secondary-prophylaxis-of-variceal-bleeding-in-cirrhosis-100639849","NCT07587671","Underdilated VCX-TIPS Versus EVL Plus NSBB for Secondary Prophylaxis of Variceal Bleeding in Cirrhosis","Underdilated VIATORR Controlled Expansion Transjugular Intrahepatic Portosystemic Shunt Versus Endoscopic Variceal Ligation Plus Nonselective Beta-Blockers for Secondary Prophylaxis of Variceal Bleeding in Patients With Cirrhosis: A Multicenter, Open-Label, Randomized Controlled Trial","U-TIPS","Inclusion Criteria:\n\n* Age 18 to 75 years, regardless of sex.\n* Diagnosis of liver cirrhosis based on previous histology, imaging, laboratory tests, and\u002For clinical manifestations.\n* Hospitalization for acute upper gastrointestinal bleeding, with endoscopic confirmation that the bleeding is related to esophageal varices or type 1 gastroesophageal varices.\n* Successful control of acute bleeding after standard acute-phase treatment, with stable vital signs and entry into the secondary prophylaxis phase.\n* Child-Pugh score of 5 to 13.\n* The investigator judges that both underdilated VCX-TIPS and EVL plus NSBB are clinically feasible and that randomization is appropriate.\n* The participant or legally authorized representative understands the study procedures and voluntarily signs written informed consent.\n\nExclusion Criteria:\n\n* Hemodynamic instability, persistent active bleeding, or need for immediate rescue TIPS, surgical hemostasis, or interventional radiologic hemostasis.\n* A strong current indication for early or pre-emptive TIPS that makes randomization to EVL plus NSBB clinically inappropriate.\n* Child-Pugh score greater than 13.\n* Previous TIPS, surgical portosystemic shunt, BRTO, CARTO, PARTO, or other procedures that substantially alter portosystemic blood flow.\n* Isolated gastric varices, type 2 gastroesophageal varices, ectopic varices, or a bleeding source other than esophageal varices or type 1 gastroesophageal varices.\n* Non-cirrhotic portal hypertension.\n* Cavernous transformation of the portal vein or portal venous thrombosis that makes standardized TIPS technically infeasible.\n* Previous recurrent or refractory overt hepatic encephalopathy, or a history of West Haven grade II to IV overt hepatic encephalopathy unrelated to gastrointestinal bleeding.\n* Severe heart failure, severe pulmonary hypertension, severe tricuspid regurgitation, right heart failure, or other contraindications to TIPS.\n* Uncontrolled severe infection, sepsis, or multiple organ failure.\n* Hepatocellular carcinoma beyond the Milan criteria or other advanced malignancy.\n* Severe renal insufficiency requiring long-term renal replacement therapy.\n* Pregnancy or breastfeeding.\n* Absolute contraindication to EVL, NSBB, or TIPS.\n* Any condition that, in the investigator's judgment, makes the participant unsuitable for the study or unable to complete follow-up.",{"count":82,"type":21},240,[24],"Variceal bleeding is a major complication of portal hypertension in patients with cirrhosis and is associated with substantial risks of rebleeding and death. Current guidelines recommend endoscopic variceal ligation combined with nonselective beta-blockers as standard secondary prophylaxis for esophageal variceal bleeding and type 1 gastroesophageal variceal bleeding. Transjugular intrahepatic portosystemic shunt can markedly reduce portal pressure and prevent recurrent variceal bleeding, but its broader use in secondary prophylaxis is limited by the risk of post-TIPS hepatic encephalopathy and liver function deterioration.\n\nThe VIATORR Controlled Expansion stent is designed to allow controlled expansion between 8 and 10 mm. However, even 8-mm TIPS may still be associated with a substantial risk of overt hepatic encephalopathy. This trial evaluates an underdilated VCX-TIPS strategy, in which a commercially available 8-10 mm VIATORR Controlled Expansion stent is initially dilated only with a 6-mm balloon, aiming to achieve sufficient portal decompression while reducing the risk of excessive shunting.\n\nThis is a prospective, multicenter, open-label, parallel-group, randomized superiority trial. Eligible patients with cirrhosis who have recovered from acute esophageal variceal bleeding or type 1 gastroesophageal variceal bleeding and have entered the secondary prophylaxis phase will be randomly assigned in a 1:1 ratio to receive either underdilated VCX-TIPS or endoscopic variceal ligation plus nonselective beta-blockers. The primary outcome is the composite of all-cause death or clinically significant upper gastrointestinal rebleeding within 1 year after randomization.",[61,86,29,87,88],"Portal Hypertension","Esophageal Varices","Hepatic Encephalopathy",[90,91,92,93,33,94,95,63],"Cirrhosis","Portal hypertension","Esophageal variceal bleeding","Secondary prophylaxis","Underdilation","Endoscopic variceal ligation","2026-05-07",{"date":98,"type":39},"2026-05-14",{"date":100,"type":21},"2026-08-01",{"date":102,"type":21},"2030-07-30",{"name":104,"class":46},"West China Hospital",3,{"id":107,"slug":108,"hasResults":11,"nctId":109,"briefTitle":110,"officialTitle":111,"acronym":4,"eligibilityCriteria":112,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":113,"targetDuration":4,"studyType":22,"phases":115,"briefSummary":116,"conditions":117,"keywords":118,"overallStatus":64,"whyStopped":4,"lastUpdateSubmitDate":121,"lastUpdatePostDateStruct":122,"startDateStruct":124,"completionDateStruct":126,"leadSponsor":128,"locationsCount":47},"100616800","efficacy-and-safety-of-variceal-embolization-combined-with-partial-splenic-artery-embolization-for-variceal-bleeding-in-cavernous-transformation-of-portal-vein-100616800","NCT07310316","Efficacy and Safety of Variceal Embolization Combined With Partial Splenic Artery Embolization for Variceal Bleeding in Cavernous Transformation of Portal Vein.","A Retrospective Cohort Study : Efficacy and Safety of Variceal Embolization Combined With Partial Splenic Artery Embolization in the Treatment of Variceal Bleeding in Cavernous Transformation of Portal Vein.","Inclusion Criteria:\n\n1. Age 18-75 years;\n2. Diagnosis of cavernous transformation of the portal vein (CTPV) confirmed by at least one imaging modality (ultrasonography, CT, or MRI);\n3. Portal vein thrombosis (PVT) extending to the splenic vein (SV) and superior mesenteric vein (SMV);\n4. History of portal hypertension complicated by variceal bleeding, with recurrent bleeding despite pharmacological and endoscopic therapies;\n5. Treated with combined variceal embolization and partial splenic artery embolization;\n6. Availability of at least one postoperative follow-up examination with documented clinical data and survival status.\n\nExclusion Criteria:\n\n1. Concomitant malignant tumor;\n2. Active infection",{"count":114,"type":21},26,[24],"The management of variceal bleeding in patients with cavernous transformation of portal vein (CTPV) generally adheres to the principles applied to cirrhotic portal hypertension, including pharmacological therapy, endoscopic intervention, transjugular intrahepatic portosystemic shunt (TIPS), and surgery. However, the distinct hemodynamic profile caused by portal vein occlusion in CTPV introduces specific therapeutic challenges: 1. Conventional pharmacological and endoscopic treatments often yield suboptimal outcomes. 2. Splenectomy with periesophagogastric devascularization is associated with significant complication rates and elevated perioperative mortality. 3. The feasibility of TIPS depends on sufficient portal venous inflow to ensure stent patency, while also carrying a risk of hepatic encephalopathy. Based on these considerations, the investigators hypothesize that for patients with extensive portal thrombosis and inadequate portal inflow who are ineligible for TIPS, a combination of variceal embolization and partial splenic artery embolization may reduce portal pressure and decrease the risk of esophagogastric variceal bleeding. To evaluate this hypothesis, a retrospective cohort study has been designed.",[28,29],[28,32,119,120],"Variceal Embolization","Partial Splenic Artery Embolization","2025-12-16",{"date":123,"type":39},"2025-12-30",{"date":125,"type":21},"2026-01-01",{"date":127,"type":21},"2026-09-30",{"name":45,"class":46}]