[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"portal-hypertension\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:portal-hypertension":30},{"pageToken":4,"total":5,"offset":6,"count":7,"results":8},null,55,0,25,[9,54,86,119,144,176,199,219,249,278,307,332,360,388,427,447,466,489,517,543,563,588,611,633,654],{"id":10,"slug":11,"hasResults":12,"nctId":13,"briefTitle":14,"officialTitle":15,"acronym":16,"eligibilityCriteria":17,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":31,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":42,"lastUpdatePostDateStruct":43,"startDateStruct":46,"completionDateStruct":48,"leadSponsor":50,"locationsCount":53},"100054285","cyanoacrylate-glue-versus-absorbable-gelatin-sponge-for-gastric-varices-100054285",false,"NCT07699354","Cyanoacrylate Glue Versus Absorbable Gelatin Sponge for Gastric Varices","Cyanoacrylate Glue Versus Absorbable Gelatin Sponge for Endoscopic Treatment of Gastric Varices (CoAGS-GV): A Randomized, Patient- and Assessor-Blinded, Non-Inferiority Trial","CoAGS-GV","Inclusion Criteria:\n\n* Adults aged 18 years or older.\n* Gastric varices deemed suitable for EUS-guided endoscopic treatment.\n* History of suspected gastric variceal bleeding or active gastric variceal bleeding, with treatment intended for secondary prophylaxis.\n* Ability to provide informed consent directly or through a substitute decision maker.\n* Willingness and ability to undergo clinical follow-up, EUS assessment, and CT imaging.\n\nExclusion Criteria:\n\n* Inability or unwillingness to provide informed consent directly or through a substitute decision maker.\n* No gastric varix present, or gastric varix too small or not amenable to combination therapy.\n* Contraindication to therapeutic EUS or endoscopy.\n* Contraindication to any study material used in the assigned treatment arm.\n* Contraindication to contrast-enhanced CT, if not clinically manageable.\n* Inability to complete planned follow-up.\n* Pregnancy.\n* Any clinical situation in which the treating endoscopist determines that randomization would be unsafe or inappropriate.","ALL","18 Years",{"count":21,"type":22},64,"ESTIMATED","INTERVENTIONAL",[25],"NA","This study compares two endoscopic ultrasound-guided treatments for gastric varices, which are enlarged veins in the stomach that can bleed. Both treatments use small coils placed into the varix. One group will receive coils with cyanoacrylate medical glue, and the other group will receive coils with absorbable gelatin sponge.\n\nThe purpose of the study is to determine whether absorbable gelatin sponge with coils is not worse than cyanoacrylate glue with coils for closing off gastric varices, and to compare safety outcomes. Participants will be randomly assigned to one of the two treatment groups. Participants and outcome assessors will not know which treatment was used, but the doctor performing the procedure will know.\n\nAfter the procedure, participants will be followed for up to 12 months. Follow-up may include clinical assessments, questionnaires about health and quality of life, CT imaging shortly after the procedure, and repeat endoscopic ultrasound assessments to evaluate whether the gastric varix has been successfully treated.",[28,29,30],"Gastric Varices Bleeding","Gastric Varices","Portal Hypertension",[32,33,34,35,36,37,38,39,40],"Endoscopic ultrasound","EUS-guided therapy","Portal hypertension","Cyanoacrylate glue","Absorbable gelatin sponge","Gelfoam","Coil embolization","Variceal obliteration","Secondary prophylaxis","NOT_YET_RECRUITING","2026-07-09",{"date":44,"type":45},"2026-07-13","ACTUAL",{"date":47,"type":22},"2026-08-01",{"date":49,"type":22},"2029-08-01",{"name":51,"class":52},"Unity Health Toronto","OTHER",1,{"id":55,"slug":56,"hasResults":12,"nctId":57,"briefTitle":58,"officialTitle":59,"acronym":60,"eligibilityCriteria":61,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":62,"targetDuration":4,"studyType":23,"phases":64,"briefSummary":65,"conditions":66,"keywords":68,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":77,"lastUpdatePostDateStruct":78,"startDateStruct":80,"completionDateStruct":82,"leadSponsor":84,"locationsCount":53},"100635553","4d-flow-mri-assessment-of-portal-hypertension-and-tips-outcomes-in-cirrhosis-100635553","NCT07554183","4D-Flow MRI Assessment of Portal Hypertension and TIPS Outcomes in Cirrhosis","Predicting Outcomes and Risk of Complications Related to Portal hyperTension by Non-invasive Assessment of Liver Flow With 4D MRI","PORTAL-4D","Inclusion Criteria:\n\nApplicable to both groups :\n\n1. Age ≥ 18 years\n2. Eligible to undergo MRI examination\n3. Prior clinical evaluation completed\n4. Covered by a national health insurance scheme or beneficiary thereof (excluding State Medical Aid AME)\n5. Patient informed and written informed consent obtained\n\n   Specific to the MASLD group :\n6. Indication for TIPS validated during a multidisciplinary team meeting and documented in the patient's medical record, including one of the following:\n\n   * Refractory ascites\n   * Hepatic hydrothorax\n   * Failure of secondary prophylaxis of variceal gastrointestinal bleeding\n   * Preemptive TIPS\n   * Preoperative TIPS\n\n   Specific to the MASLD group :\n7. Past or current exposure to metabolic risk factors (overweight, obesity, type 2 diabetes mellitus, arterial hypertension, dyslipidemia)\n8. Liver stiffness \\> 15 kPa measured by transient elastography\n9. Liver biopsy documenting steatosis with stage 3 fibrosis or cirrhosis\n10. Alcohol consumption \\\u003C 20 g\u002Fday for women and \\\u003C 30 g\u002Fday for men, assessed using validated routine clinical questionnaires\n\nExclusion Criteria:\n\nApplicable to both groups :\n\n1. Any contraindication to MRI (cardiac pacemaker, implantable cardioverter-defibrillator, cochlear implants, intraocular metallic foreign bodies, intracranial vascular clips).\n2. Prior liver transplantation.\n3. Pregnancy, breastfeeding, or women of childbearing potential not using effective contraception.\n4. Individual under legal guardianship or trusteeship, or unable to provide informed consent.\n5. Participation in another interventional clinical study or currently within the exclusion period following a previous ongoing study.\n\n   Specific to the TIPS group\n6. Patients undergoing salvage TIPS placement in the setting of hemorrhagic shock. Specific to the MASLD group\n7. Other etiologies of chronic liver disease, including viral hepatitis, autoimmune liver disease, or hemochromatosis",{"count":63,"type":22},60,[25],"PORTAL-4D is a prospective, interventional, non-randomized, parallel-group diagnostic study conducted at Pitié-Salpêtrière Hospital (Paris, France).\n\nPortal hypertension is the main driver of hepatic decompensation and is associated with ascites, variceal bleeding, hepatic encephalopathy, and reduced survival. The current gold standard for assessing portal hypertension is the invasive hepatic venous pressure gradient (HVPG) measurement performed via the transjugular route. However, HVPG is invasive, operator-dependent, and limited to specialized centers. A reliable non-invasive alternative is therefore highly needed.\n\n60 adults patients with cirrhosis will be enrolled and divided into two parallel groups: MASLD group (n=24): Patients with compensated cirrhosis related to metabolic dysfunction-associated steatotic liver disease (MASLD).\n\nTIPS group (n=36): Patients with decompensated cirrhosis referred for transjugular intrahepatic portosystemic shunt (TIPS) placement.\n\nThe primary objective is to assess the correlation between invasive HVPG values and 4D-flow MRI parameters. Secondary objectives include evaluating the prognostic value of 4D-flow MRI in predicting portal hypertension-related complications and post-TIPS outcomes within 6 months.\n\nThe study is expected to validate 4D-flow MRI as an non-invasive diagnostic and prognostic tool for portal hypertension, potentially improving patient selection for TIPS and reducing reliance on invasive procedures.",[67,30],"Cirrhosis",[69,70,71,72,73,74,75,76],"4D-Flow MRI","Hepatic Venous Pressure Gradient","Portal Hemodynamics","Noninvasive Liver Imaging","Hepatic Encephalopathy","Portal hypertension complications","TIPS","MASLD","2026-06-22",{"date":79,"type":45},"2026-06-24",{"date":81,"type":22},"2026-06-01",{"date":83,"type":22},"2028-05-01",{"name":85,"class":52},"Assistance Publique - Hôpitaux de Paris",{"id":87,"slug":88,"hasResults":12,"nctId":89,"briefTitle":90,"officialTitle":91,"acronym":4,"eligibilityCriteria":92,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":93,"enrollmentInfo":94,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":97,"conditions":98,"keywords":104,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":108,"lastUpdatePostDateStruct":109,"startDateStruct":111,"completionDateStruct":113,"leadSponsor":115,"locationsCount":118},"100523693","cera-vascular-plug-system-post-market-clinical-follow-up-100523693","NCT06099015","Cera™ Vascular Plug System Post-Market Clinical Follow-Up","Cera™ Vascular Plug System Post-Market Clinical Follow-Up: A Multi-center, Prospective, Observational, Single-arm, Open-label, Post-market Study","Inclusion Criteria:\n\n1. Aged 18 to 85;\n2. Life expectancy \\> 1 year;\n3. Require arterial or venous embolization in the peripheral vasculature;\n4. Target embolization site(s) allow for safe insertion of the delivery catheter;\n5. Voluntarily sign and date the Informed Consent Form (ICF) prior to any study-related activities commencement;\n6. Willing and able to comply with protocol requirements, including all study visits and procedures.\n7. Patients for whom the doctor has decided to use the Cera Vascular Plug System, regardless of the study.\n\nExclusion Criteria:\n\n1. The subject is pregnant or plan to be pregnant or breast feeding;\n2. The subject has a known allergy or hypersensitivity to any of the device materials including: nickel, stainless steel, polytetrafluoroethylene and titanium nitride;\n3. The subject has a known allergy or hypersensitivity to contrast agent;\n4. The subject has uncorrectable coagulopathy;\n5. The subject has planned use of anticoagulant (e.g. direct thrombin inhibitors, factor Xa inhibitors, vitamin K antagonists) or antiplatelet therapy before, during and\u002For after treatment with the study device, which, in the opinion of the Investigator, would clinically interfere with the study endpoints\n6. The subject has an unresolved systemic infection;\n7. Subject who cannot tolerate general or local anesthesia;\n8. The subject has a connective tissue disorders (e.g. Ehlers-Danlos Syndrome), arteritis (e.g. Takayasu's Disease) or another circulatory disorder;\n9. The subject is participating in other drug or medical device clinical trials;\n10. Any condition (medical or anatomic) making the subject not suitable for transcatheter embolotherapy according to the opinion of the investigator.","85 Years",{"count":95,"type":22},132,"OBSERVATIONAL","The objective of the study is to collect and evaluate clinical data on patients of the Lifetech Cera™ Vascular Plug System to:\n\n* confirm the performance\n* confirm the safety\n* identify previously unknown side-effects\n* monitor the identified side-effects (related to the procedures or to the medical devices)\n* identify and analyse emergent risks",[99,100,101,30,102,103],"Aneurysm","Endoleak","Pulmonary Arteriovenous Malformation","Arteriovenous Fistula","Splenic Laceration",[105,106],"Lifetech","Cera Vascular Plug","RECRUITING","2026-06-10",{"date":110,"type":45},"2026-06-12",{"date":112,"type":45},"2024-06-21",{"date":114,"type":22},"2028-06-30",{"name":116,"class":117},"Lifetech Scientific (Shenzhen) Co., Ltd.","INDUSTRY",9,{"id":120,"slug":121,"hasResults":12,"nctId":122,"briefTitle":123,"officialTitle":124,"acronym":125,"eligibilityCriteria":126,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":127,"targetDuration":129,"studyType":96,"phases":4,"briefSummary":130,"conditions":131,"keywords":4,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":134,"lastUpdatePostDateStruct":135,"startDateStruct":137,"completionDateStruct":139,"leadSponsor":141,"locationsCount":143},"100640745","austrian-pbc-registry-100640745","NCT07598669","Austrian PBC Registry","Characterisation of Patients With Primary Biliary Cholangitis in Austria - A Prospective Registry and Biobank","PBC-AUT","Inclusion Criteria:\n\n* Age \\>18 years\n* Confirmed diagnosis of primary biliary cholangitis (at least two of the following three criteria must be fulfilled: persistent elevation of alkaline phosphatase above the upper limit of normal for at least 6 months; presence of antimitochondrial antibodies or PBC-specific antinuclear antibodies; characteristic histopathology)\n* Written informed consent for participation in the registry\n\nExclusion Criteria:\n\n* Withdrawal of written informed consent",{"count":128,"type":22},500,"10 Years","The goal of this registry is to better understand how primary biliary cholangitis develops over time, including the role of disease-related biomarkers, complications of the disease, and symptom burden. Patients with primary biliary cholangitis treated at participating centres in Austria will be invited to take part in this prospective registry. Participation in an associated biobank is optional. Clinical and laboratory data will be collected, and patients will be followed regularly through scheduled clinic visits. In addition, biological samples (serum, plasma, and, if available, liver tissue) may be collected and stored in the biobank for future research.",[132,133,30],"Primary Biliary Cholangitis","Liver Cirrhosis","2026-05-16",{"date":136,"type":45},"2026-05-20",{"date":138,"type":45},"2026-03-18",{"date":140,"type":22},"2040-12",{"name":142,"class":52},"Medical University of Vienna",11,{"id":145,"slug":146,"hasResults":12,"nctId":147,"briefTitle":148,"officialTitle":149,"acronym":150,"eligibilityCriteria":151,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":152,"enrollmentInfo":153,"targetDuration":155,"studyType":96,"phases":4,"briefSummary":156,"conditions":157,"keywords":161,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":167,"lastUpdatePostDateStruct":168,"startDateStruct":170,"completionDateStruct":172,"leadSponsor":174,"locationsCount":4},"100640414","effect-of-lsd-on-renal-function-in-cirrhosis-patients-with-portal-hypertension-bleeding-2-year-follow-up-100640414","NCT07585786","Effect of LSD on Renal Function in Cirrhosis Patients With Portal Hypertension Bleeding (2-Year Follow-Up)","A Prospective, Single-Center, Observational Cohort Study to Evaluate the Long-Term (2-Year) Effects of Laparoscopic Splenectomy and Azygoportal Disconnection on Renal Function in Patients With Liver Cirrhosis, Portal Hypertension Bleeding","LSD-RFPH","Inclusion Criteria:\n\n1. Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging)\n2. Splenomegaly and hypersplenism\n3. History of portal hypertension bleeding (esophageal and gastric variceal bleeding )\n4. Age 18-80 years, male or female\n5. Child-Pugh Class A or B liver function\n6. No history of primary renal disease or acute kidney injury (AKI)\n7. Signed written informed consent\n8. Ability to complete 24-month follow-up\n\nExclusion Criteria:\n\n1. Child-Pugh Class C liver cirrhosis\n2. Primary renal diseases (glomerulonephritis, polycystic kidney disease, chronic pyelonephritis, etc.)\n3. Previous abdominal surgery precluding safe laparoscopic splenectomy and azygoportal disconnection\n4. Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders\n5. Hepatic encephalopathy or refractory ascites within 1 month before surgery\n6. Pregnancy or lactation\n7. Poor compliance, inability to complete follow-up","80 Years",{"count":154,"type":22},30,"2 Years","Patients with liver cirrhosis often have impaired or at-risk kidney function due to the close link between liver and kidney (hepatorenal syndrome). Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) is commonly used to treat Cirrhosis with Portal Hypertension Bleeding in these patients, but its impact on kidney function over 2 years is unclear. This study will follow patients undergoing laparoscopic splenectomy to measure changes in kidney function before and after surgery, identify risk factors for kidney damage and whether LSD can improve kidney function in the long term, and help improve care to protect kidney function in cirrhotic patients .",[158,159,160,30],"Cirrhosis, Liver","Splenectomy; Status","Renal Function Abnormal",[67,162,163,164,165,166],"Splenectomy","Laparoscopy","azygoportal disconnection","Renal function","Portal hypertension bleeding","2026-05-14",{"date":169,"type":45},"2026-05-18",{"date":171,"type":22},"2026-05-01",{"date":173,"type":22},"2029-02-28",{"name":175,"class":52},"Northern Jiangsu People's Hospital",{"id":177,"slug":178,"hasResults":12,"nctId":179,"briefTitle":180,"officialTitle":181,"acronym":4,"eligibilityCriteria":182,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":183,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":185,"conditions":186,"keywords":188,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":191,"lastUpdatePostDateStruct":192,"startDateStruct":193,"completionDateStruct":195,"leadSponsor":197,"locationsCount":53},"100620518","treatment-outcomes-for-portal-hypertension-esophageal-and-gastric-varices-100620518","NCT07358663","Treatment Outcomes for Portal Hypertension Esophageal and Gastric Varices","Assessment of Treatment Outcomes for Esophageal and Gastric Varices Secondary to Portal Hypertension","Inclusion Criteria:\n\n* Clinical diagnosis of portal hypertension with esophagogastric varices.\n* Underwent abdominal CT and gastroscopy examinations.\n\nExclusion Criteria:\n\n* Presence of peptic ulcer, gastric tumor, or other causes of gastrointestinal bleeding confirmed by imaging or gastroscopy.\n* CT images of inadequate quality or incomplete medical history data.",{"count":184,"type":22},1384,"This study is a single-center, prospective cohort study based on real-world data. Patients with portal hypertension and esophagogastric varices were enrolled and divided into an endoscopic treatment group and a non-endoscopic treatment group (including patients receiving medical therapy, interventional procedures, or surgical treatment) according to whether they underwent endoscopic intervention. Baseline data, serum metabolites, CT imaging and endoscopic images, liver biopsy pathology, and other multi-omics data were integrated for both groups. Patients were followed up to compare adverse events after variceal treatment, including rebleeding and its causes, hepatic encephalopathy, ascites, subsequent treatments (such as regular endoscopic therapy, NSSB, and TIPS), and survival outcomes. Clinical characteristics of portal hypertension attributed to different etiologies, including hepatitis B, autoimmune liver disease, schistosomiasis, hematological disorders, and chemotherapy-induced liver injury, were compared. The efficacy and safety of endoscopic and interventional treatments for esophagogastric varices were evaluated. Factors influencing rebleeding rates among different treatment groups were analyzed, and reasons for inclusion in different groups were discussed.",[187,30],"Esophagogastric Varices",[189,190],"endoscopic treatment","portal hypertension","2026-05-12",{"date":167,"type":45},{"date":194,"type":45},"2026-01-20",{"date":196,"type":22},"2028-12-31",{"name":198,"class":52},"Shanghai Zhongshan Hospital",{"id":200,"slug":201,"hasResults":12,"nctId":202,"briefTitle":203,"officialTitle":204,"acronym":205,"eligibilityCriteria":206,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":152,"enrollmentInfo":207,"targetDuration":155,"studyType":96,"phases":4,"briefSummary":208,"conditions":209,"keywords":211,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":214,"lastUpdatePostDateStruct":215,"startDateStruct":216,"completionDateStruct":217,"leadSponsor":218,"locationsCount":53},"100638416","effect-of-lsd-on-lipid-profiles-in-cirrhosis-patients-with-portal-hypertension-bleeding-2-year-follow-up-100638416","NCT07588334","Effect of LSD on Lipid Profiles in Cirrhosis Patients With Portal Hypertension Bleeding (2-Year Follow-Up)","A Prospective, Single-Center, Observational Cohort Study to Evaluate the Long-Term (2-Year) Effects of Laparoscopic Splenectomy and Azygoportal Disconnection on Lipid Profiles in Patients With Liver Cirrhosis, Portal Hypertension Bleeding.","LSD-LPPH","Inclusion Criteria:\n\n1. Age 18-80 years, male or female\n2. Confirmed diagnosis of liver cirrhosis (clinical, laboratory, imaging)\n3. Splenomegaly and hypersplenism\n4. History of portal hypertension bleeding (esophageal and gastric variceal bleeding )\n5. Child-Pugh Class A or B liver function\n6. Signed written informed consent\n7. Ability to complete 24-month follow-up\n\nExclusion Criteria:\n\n1. Child-Pugh Class C liver cirrhosis\n2. Previous abdominal surgery precluding safe laparoscopic splenectomy and azygoportal disconnection\n3. Severe cardiac, pulmonary, cerebrovascular dysfunction; malignant tumors; primary hematological disorders\n4. Metabolic\u002Fendocrine diseases: Familial hyperlipidemia; uncontrolled severe diabetes mellitus, thyroid dysfunction, nephrotic syndrome; use of lipid-lowering drugs, hormones, or other drugs affecting blood lipids within 1 month before surgery.\n5. Infections\u002Finflammatory diseases: Active hepatitis, severe infections, or autoimmune diseases.\n6. Cirrhotic complications (hepatic encephalopathy, refractory ascites) within 1 month before surgery\n7. Pregnancy or lactation\n8. Poor compliance, inability to complete follow-up",{"count":154,"type":22},"Patients with liver cirrhosis frequently exhibit dyslipidemia due to impaired hepatic lipid synthesis, altered bile acid metabolism, and portal hypertension. Laparoscopic Splenectomy and Azygoportal Disconnection (LSD) is commonly used to treat Cirrhosis with Portal Hypertension Bleeding in these patients, but its impact on lipid profiles over 2 years remains poorly characterized. This study will follow patients undergoing LSD to measure changes in serum lipid parameters before and after surgery, identify risk factors for lipid profile deterioration or improvement, and determine whether LSD can ameliorate dyslipidemia in the long term, thereby informing metabolic management strategies in cirrhotic patients.",[158,159,30,210],"Lipid Profiles",[67,162,163,210,164,212,213],"Portal Hypertension Bleeding","hypersplenism","2026-05-10",{"date":167,"type":45},{"date":171,"type":22},{"date":173,"type":22},{"name":175,"class":52},{"id":220,"slug":221,"hasResults":12,"nctId":222,"briefTitle":223,"officialTitle":224,"acronym":225,"eligibilityCriteria":226,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":227,"enrollmentInfo":228,"targetDuration":4,"studyType":23,"phases":230,"briefSummary":231,"conditions":232,"keywords":235,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":241,"lastUpdatePostDateStruct":242,"startDateStruct":243,"completionDateStruct":244,"leadSponsor":246,"locationsCount":248},"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.","75 Years",{"count":229,"type":22},240,[25],"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.",[133,30,233,234,73],"Gastroesophageal Varices Bleeding","Esophageal Varices",[67,34,236,40,237,238,239,240],"Esophageal variceal bleeding","Transjugular intrahepatic portosystemic shunt","Underdilation","Endoscopic variceal ligation","Hepatic encephalopathy","2026-05-07",{"date":167,"type":45},{"date":47,"type":22},{"date":245,"type":22},"2030-07-30",{"name":247,"class":52},"West China Hospital",3,{"id":250,"slug":251,"hasResults":12,"nctId":252,"briefTitle":253,"officialTitle":254,"acronym":4,"eligibilityCriteria":255,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":256,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":258,"conditions":259,"keywords":264,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":269,"lastUpdatePostDateStruct":270,"startDateStruct":272,"completionDateStruct":274,"leadSponsor":276,"locationsCount":4},"100636914","ultrasound-prediction-of-esophageal-variceal-bleeding-risk-100636914","NCT07571876","Ultrasound Prediction of Esophageal Variceal Bleeding Risk","Splenic Size and Portal Vein Diameter on Ultrasound in Predicting Esophageal Variceal Bleeding Risk","Inclusion Criteria:\n\n* Adult patients (age ≥18 years) with chronic liver disease and clinical\u002Flaboratory\u002Fradiological evidence of liver cirrhosis\n* Both compensated and decompensated cirrhosis (Child-Pugh classes A, B, and C)\n* Patients scheduled for upper gastrointestinal endoscopy\n* Patients who provide informed consent\n\nExclusion Criteria:\n\n* Previous history of endoscopic variceal band ligation or sclerotherapy\n* Prior surgical portosystemic shunt procedures or transjugular intrahepatic portosystemic shunt (TIPS)\n* Hepatocellular carcinoma with portal vein thrombosis\n* Previous splenectomy\n* Patients receiving beta-blockers for variceal bleeding prophylaxis\n* Poor quality ultrasound images due to obesity or ascites\n* Refusal to participate in the study",{"count":257,"type":22},165,"This prospective observational study aims to evaluate the accuracy of using routine abdominal ultrasound to predict the risk of esophageal variceal bleeding in adult patients with liver cirrhosis. Esophageal variceal bleeding is a serious complication of chronic liver disease. While upper gastrointestinal endoscopy is the current standard for diagnosing and grading these varices, it is an invasive procedure.\n\nIn this study, researchers will use ultrasound to measure the patient's spleen size and portal vein diameter. These non-invasive measurements will then be compared to the results of a standard upper endoscopy performed within 48 to 72 hours. The goal is to determine if these simple ultrasound measurements can reliably predict the presence, grade, and bleeding risk of esophageal varices, which could potentially reduce the need for routine invasive endoscopic screenings in the future.",[260,261,262,234,133,30,263],"Variceal Bleeding","Ultrasonography","Esophageal Bleeding","Chronic Liver Disease (CLD)",[265,266,267,268],"portal vein diameter","splenic size","ultrasound","esophageal variceal bleeding risk","2026-05-04",{"date":271,"type":45},"2026-05-06",{"date":273,"type":22},"2026-04",{"date":275,"type":22},"2027-05",{"name":277,"class":52},"Assiut University",{"id":279,"slug":280,"hasResults":12,"nctId":281,"briefTitle":282,"officialTitle":283,"acronym":4,"eligibilityCriteria":284,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":285,"enrollmentInfo":286,"targetDuration":4,"studyType":23,"phases":288,"briefSummary":289,"conditions":290,"keywords":292,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":298,"lastUpdatePostDateStruct":299,"startDateStruct":301,"completionDateStruct":303,"leadSponsor":305,"locationsCount":53},"100616350","effects-of-terlipressin-and-somatostatin-on-portal-pressure-in-patients-undergoing-living-donor-liver-transplantation-100616350","NCT07304466","Effects of Terlipressin and Somatostatin on Portal Pressure in Patients Undergoing Living Donor Liver Transplantation","Comparison of the Effects of Terlipressin and Somatostatin on Portal Pressure in Patients Undergoing Living Donor Liver Transplantation","Inclusion Criteria:\n\nPatients scheduled for right lobe living donor liver transplantation with clinically significant portal hypertension (esophageal varices, thrombocytopenia (\\\u003C100,000), ascites, encephalopathy; Child-Turcotte-Pugh class B-C)\n\nExclusion Criteria:\n\n* Allergy to any of the medications to be used\n* Portal vein thrombosis\n* Being treated with terlipressin with a diagnosis of hepatorenal syndrome\n* Portopulmonary hypertension\n* Acute on chronic liver failure\n* Chronic renal failure (glomerular filtration rate ≤ 30%)\n* Myocardial ischemia\n* Uncontrolled hypertension\n* Arrhythmia\n* Multiple solid organ transplantation","70 Years",{"count":287,"type":22},50,[25],"The goal of this clinical trial is to compare the effects of somatostatin and terlipressin on lowering portal pressure in patients with portal hypertension undergoing liver transplantation, and to investigate whether there are differences in clinical outcomes between the two drugs. The study will evaluate the decrease in portal pressure from baseline following drug administration at defined time points. It will also compare the effects of these drugs on hemodynamics, bleeding, and transfusion requirements. After baseline intraoperative direct portal pressure measurement, a bolus dose of the study drug will be administered, followed by continuous intravenous infusion intraoperatively and for 24 hours postoperatively. Direct portal pressure will be measured again 5 minutes after the bolus dose, after the portal vein anastomosis, after the hepatic artery anastomosis, and, if performed after splenic artery ligation. Hemodynamic parameters will be recorded, and the drugs will be compared in terms of their intraoperative hemodynamic effects. As elevated portal pressure is associated with increased bleeding, intraoperative blood loss and transfusion needs will also be assessed between the groups. Patients will be followed for 7 days postoperatively for clinical and laboratory outcomes.",[291,30],"Liver Transplantation",[293,294,190,295,296,297],"liver transplantation","portal pressure","living donor liver transplantation","somatostatin","terlipressin","2026-04-27",{"date":300,"type":45},"2026-04-29",{"date":302,"type":45},"2025-12-29",{"date":304,"type":22},"2027-03-30",{"name":306,"class":52},"Istanbul Medipol University Hospital",{"id":308,"slug":309,"hasResults":12,"nctId":310,"briefTitle":311,"officialTitle":312,"acronym":313,"eligibilityCriteria":314,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":152,"enrollmentInfo":315,"targetDuration":4,"studyType":23,"phases":317,"briefSummary":318,"conditions":319,"keywords":321,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":298,"lastUpdatePostDateStruct":325,"startDateStruct":326,"completionDateStruct":328,"leadSponsor":330,"locationsCount":53},"100560422","early-tips-in-patients-with-liver-cirrhosis-and-ascites-100560422","NCT06576934","Early TIPS in Patients With Liver Cirrhosis and Ascites","Early Implantation of a Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Patients With Liver Cirrhosis and Ascites: a Multicentre, Randomised Controlled Trial","eTIPS","Inclusion Criteria:\n\nPatients eligible for inclusion in this trial must meet all of the following criteria:\n\n1. Patients ≥ 18 years and \\\u003C 80 years\n2. Liver cirrhosis as documented by previous liver biopsy or by a combination of typical clinical, biochemical and sonographic features\n3. Ascites as the first single decompensating event with grade 2 ascites and MELD ≥ 15 OR grade 3 ascites\n4. INR ≤ 1.5\n5. Ability to understand the nature of the trial and the trial related procedures and to comply with them\n\nExclusion Criteria:\n\nPatients eligible for this trial must not meet any of the following criteria:\n\n1. Treatment refractory or recurrent ascites at the time of study inclusion\n2. Patients with concomitant variceal bleeding fulfilling the criteria for pre-emptive TIPS implantation (Child-Pugh class C \\\u003C 14 points or Child-Pugh class B \\>7 with active bleeding at initial endoscopy or hepatic venous pressure gradient \\[HVPG\\] \\> 20 mmHg at the time of bleeding)\n3. Budd-Chiari syndrome\n4. Portal vein thrombosis (PVT)\n5. Spontaneous bacterial peritonitis (SBP)\n6. Uncontrolled systemic infection (defined as an increase of \\> 20% if inflammatory parameters \\[C-reactive protein, procalcitonin, leukocytes\\] and\u002For sepsis as a reason for development of ascites\n7. Cardiac cirrhosis (defined as the development of liver cirrhosis in a patient with cardiac heart failure due to primary cardiac disease)\n8. Clinical significant cardiac disease (NYHA ≥II)\n9. Untreated valvular heart disease: middle to high-grade valve stenosis or insufficiency (applies to mitral, tricuspid, aortic and pulmonary valves)\n10. Diastolic dysfunction grade III, stated by transthoracic echocardiogram (TTE)\n11. Reduced left ventricular ejection fraction ≤50%\n12. Pulmonary hypertension (mean pulmonary arterial pressure \\> 45 mmHg)\n13. Bilirubin \\> 3 mg\u002Fdl\n14. Obstructive cholestasis\n15. Hepatorenal syndrome type AKI (HRS-AKI)\n16. Acute on chronic liver failure\n17. Benign liver tumor within the potential puncture tract\n18. Patient after liver transplantation\n19. Prior TIPS implantation\n20. Ongoing and\u002For recurrent hepatic encephalopathy (grade \\>II)\n21. Active tumor disease including hepatocellular carcinoma defined as need for chemotherapy, radiation therapy, interventional or surgical treatment\n22. New onset of antiviral treatment for chronic hepatitis B virus (HBV) infection within the last 3 months\n23. Untreated chronic hepatitis C virus (HCV) infection\n24. Life expectancy \\\u003C1 year\n25. Pregnant or breastfeeding women\n26. Patients without the legal capacity who are unable to understand the nature, significance and consequences of the study\n27. Simultaneous participation in other interventional trials which could interfere with this trial; simultaneous participation in registry and diagnostic trials is allowed\n28. Person who is in a relationship of dependence\u002Femployment with the sponsor or the investigator",{"count":316,"type":22},134,[25],"The aim of this clinical trial is to compare the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) implantation with standard treatment (diuretic medications, and if necessary, paracenteses) in patients with liver cirrhosis and development of ascites as the first decompensating event.\n\nBy creating a shunt between the liver vein and the portal vein, blood is diverted from the portal vein directly into the hepatic vein, which results in a reduction of pressure in the portal vein so that development of ascites is reduced.",[133,320,30],"Ascites Hepatic",[322,237,323,324],"liver cirrhosis","ascites","MELD",{"date":171,"type":45},{"date":327,"type":45},"2025-04-01",{"date":329,"type":22},"2029-02-15",{"name":331,"class":52},"University Hospital Freiburg",{"id":333,"slug":334,"hasResults":12,"nctId":335,"briefTitle":336,"officialTitle":337,"acronym":338,"eligibilityCriteria":339,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":340,"enrollmentInfo":341,"targetDuration":343,"studyType":96,"phases":4,"briefSummary":344,"conditions":345,"keywords":350,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":298,"lastUpdatePostDateStruct":354,"startDateStruct":355,"completionDateStruct":357,"leadSponsor":359,"locationsCount":53},"100499384","freiburg-tips-registry-100499384","NCT05782556","Freiburg TIPS Registry","Transjugular Intrahepatic Portosystemic Shunt (TIPS) for the Treatment of Portal Hypertension: an Observational Study","FRETIR","Inclusion Criteria:\n\n* Patients allocated to TIPS implantation due to clinically significant cirrhotic and non-cirrhotic portal hypertension\n\nExclusion Criteria:\n\n* Withdrawal of written informed consent","100 Years",{"count":342,"type":22},2000,"12 Months","Patients with clinically significant portal hypertension allocated to implantation of a transjugular intrahepatic portosystemic shunt (TIPS) at the Department of Medicine II of the University Medical Center Freiburg, Germany will be offered to participate in this prospective observational trial.\n\nClinical and laboratory as well as outcome parameters will be assessed before and within the first 12 months after TIPS implantation following a regular follow-up schedule with clinical visits at the University Medical Center Freiburg. During follow-up visits, serum\u002Fplasma samples and peripheral blood mononuclear cells (PBMC) are collected and stored in a associated biobank.",[133,30,346,347,348,349],"Non-Cirrhotic Portal Hypertension","Budd Chiari Syndrome","Portal Vein Thrombosis","Portal Systemic Shunt",[351,237,346,352,353],"Liver cirhosis","Prognosis","Outcome",{"date":171,"type":45},{"date":356,"type":45},"2023-01-01",{"date":358,"type":22},"2034-06-30",{"name":331,"class":52},{"id":361,"slug":362,"hasResults":12,"nctId":363,"briefTitle":364,"officialTitle":364,"acronym":365,"eligibilityCriteria":366,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":367,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":369,"conditions":370,"keywords":371,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":380,"lastUpdatePostDateStruct":381,"startDateStruct":383,"completionDateStruct":385,"leadSponsor":387,"locationsCount":53},"100626769","exploration-of-systemic-and-portal-hemostasis-in-patients-undergoing-transjugular-intrahepatic-portosystemic-shunt-placement-100626769","NCT07439939","Exploration of Systemic and Portal Hemostasis in Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt Placement","PORTHEMOST","Inclusion Criteria:\n\n* Adult patients (aged ≥18 years) covered by a social security scheme or entitled beneficiaries\n* Patients followed for a cirrhotic condition at Paul Brousse Hospital and undergoing placement of a TIPS (transjugular intrahepatic portosystemic shunt)\n\nExclusion Criteria:\n\n* Patient unwilling to participate in the study\n* Patient with a contraindication to TIPS placement\n* Patient with a known hemostatic disorder unrelated to cirrhosis\n* Patient receiving treatment that interferes with hemostasis and has not been discontinued for the procedure\n* Patient receiving systemic corticosteroid therapy\n* Patient under legal protection\n* Patient not covered by a social security scheme",{"count":368,"type":22},45,"Portal vein thrombosis is defined as non-tumoural obstruction of the portal vein or one of its branches. Its incidence is 0.7 to 2.7 per 100,000 patient-years in the general population, and 4.6 per 100 patient-years in patients with cirrhosis. Histological modificaitions fo the portal vein wall and haemostatic changes have been described in cirrhotic patients. The contribution of these changes, both systemic and local, to the development of portal vein thrombosis is debated. One of the hypotheses put forward on the genesis of portal vein thrombosis is as follows: certain bacterial translocations from the digestive tract, promoted by portal hypertension, contribute to endothelial activation resulting in the release of von Willebrand factor and factor VIII, as well as platelet activation and the coagulation cascade, which is dysregulated by cirrhosis and underlying changes in haemostatic balance. Inflammatory phenomena and NETosis may also be involved. Studies suggest that cirrhotic patients have lesions of the glycocalyx located in the portal area, which may be involved in the development of portal vein thrombosis. Patients with cirrhosis may benefit from the placement of a transjugular intrahepatic portosystemic shunt (TIPS). During the TIPS placement procedure, blood is drawn from the internal jugular vein and the portal vein, allowing for parallel biological analyses. The assumption of this study is that haemostasis and inflammation are disrupted differently at the systemic and portal levels in cirrhotic patients.",[133,30],[322,190,372,373,374,375,376,377,378,379],"Transjugular Intrahepatic Portosystemic Shunt","Primary Hemostasis","Blood Coagulation","Fibrinolysis","Thromboinflammation","von Willebrand Factor","Endothelial Dysfunction","Portal Circulation","2026-04-20",{"date":382,"type":45},"2026-04-21",{"date":384,"type":45},"2026-03-09",{"date":386,"type":22},"2027-06-09",{"name":85,"class":52},{"id":389,"slug":390,"hasResults":12,"nctId":391,"briefTitle":392,"officialTitle":393,"acronym":394,"eligibilityCriteria":395,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":396,"targetDuration":4,"studyType":23,"phases":398,"briefSummary":400,"conditions":401,"keywords":404,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":418,"lastUpdatePostDateStruct":419,"startDateStruct":421,"completionDateStruct":423,"leadSponsor":425,"locationsCount":53},"100633026","phase-4-apixaban-pk-trial-preventing-portal-hypertension-complications-in-cirrhosis-100633026","NCT07521332","Apixaban-PK Trial: Preventing Portal Hypertension Complications in Cirrhosis","Apixaban Plus Carvedilol to Prevent Portal Hypertension Complications in Cirrhosis: A Randomized Single-Blind Placebo-Controlled Trial at AIMS, Hyderabad, Pakistan","APIXABAN-PK","Inclusion Criteria:\n\n1. Adults aged ≥18 years with diagnosed cirrhosis (any etiology), confirmed by histology, transient elastography (≥12.5 kPa), or consistent clinical\u002Fimaging findings.\n2. Evidence of portal hypertension, defined by:\n\n   Clinical: presence of varices on endoscopy, ascites, or splenomegaly with thrombocytopenia.\n3. Compensated or early decompensated cirrhosis (Child-Pugh B 7-10), with stable liver function defined as no change in Child-Pugh score \\>1 point in the preceding 3 months.\n4. Screening esophagogastroduodenoscopy (EGD) performed within 6 months prior to enrollment. Patients with high-risk varices (large varices, red wale signs, or history of variceal bleeding) must undergo endoscopic variceal band ligation to obliteration before randomization.\n5. Able to provide informed consent and comply with study procedures.\n\nExclusion Criteria:\n\n1. Active gastrointestinal bleeding within 6 weeks prior to enrollment.\n2. High bleeding risk:\n\n   * Platelet count \\\u003C50,000\u002FµL at baseline\n   * INR \\>1.8 (or \\>2.0 if secondary to cirrhosis without additional coagulopathy)\n   * Active peptic ulcer disease\n   * History of intracranial hemorrhage or hemorrhagic stroke\n   * Known bleeding diathesis\n3. Severe renal impairment (eGFR \\\u003C 30 mL\u002Fmin\u002F1.73 m²) or on dialysis.\n4. Child-Pugh class C or Child-Pugh score ≥10.\n5. History of hypersensitivity to apixaban or carvedilol.\n6. Pregnancy, breastfeeding, or unwillingness to use effective contraception during the study period.\n7. Concurrent anticoagulant or antiplatelet therapy (including aspirin, clopidogrel, warfarin, or other DOACs) that cannot be safely discontinued. A washout period of at least 5 half-lives is required before randomization.\n8. Use of NSAIDs, SSRIs, or other medications that significantly increase bleeding risk, unless approved by the PI with clear risk-benefit justification.\n9. Active hepatocellular carcinoma (HCC) outside Milan criteria or with vascular invasion.\n10. Current or planned liver transplantation.",{"count":397,"type":22},220,[399],"PHASE4","The APIXABAN-PK trial is a prospective, randomized, single-blind, placebo-controlled study designed to evaluate the efficacy and safety of apixaban in combination with carvedilol versus placebo with carvedilol in preventing portal hypertension-related complications in patients with cirrhosis. Conducted at the Gastroenterology and Hepatology Department and Clinical Trials Unit (CTU) of Asian Institute of Medical Sciences (AIMS) Hospital, Hyderabad, Pakistan, the trial will enroll eligible cirrhotic patients with portal hypertension. Participants will be followed for 12 months to monitor hepatic decompensation events, variceal bleeding, portal vein thrombosis, and mortality, while safety and tolerability of apixaban will be closely assessed. This study aims to provide local evidence for apixaban use in cirrhosis management in Pakistan.",[67,402,403,73,348,30],"Esophageal and Gastric Varices","Ascites",[405,406,407,190,408,409,410,411,412,413,414,415,416,417],"apixaban","carvedilol","cirrhosis","direct oral anticoagulant","variceal bleeding","hepatic decompensation","portal vein thrombosis","randomized controlled trial","Pakistan","Factor Xa Inhibitor","non-selective beta-blocker","prevention","liver disease","2026-04-03",{"date":420,"type":45},"2026-04-09",{"date":422,"type":45},"2026-04-01",{"date":424,"type":22},"2028-04-01",{"name":426,"class":52},"Asian Institute Of Medical Sciences",{"id":428,"slug":429,"hasResults":12,"nctId":430,"briefTitle":431,"officialTitle":432,"acronym":4,"eligibilityCriteria":433,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":434,"targetDuration":343,"studyType":96,"phases":4,"briefSummary":436,"conditions":437,"keywords":4,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":439,"lastUpdatePostDateStruct":440,"startDateStruct":442,"completionDateStruct":444,"leadSponsor":446,"locationsCount":4},"100631595","optimizing-endoscopic-and-interventional-treatment-for-portal-hypertensive-bleeding-100631595","NCT07502729","Optimizing Endoscopic and Interventional Treatment for Portal Hypertensive Bleeding","Improve the Strategies of Endoscopic and Interventional Treatment of Gastroesophageal Hemorrhage in Portal Hypertension","Inclusion Criteria:\n\n* Admitted due to gastrointestinal bleeding and clinically diagnosed with portal hypertension\n* Underwent imaging examinations and gastroscopy within one week after admission\n* Gastroscopy revealed the presence of esophageal and\u002For gastric varices\n* Age over 18 years\n\nExclusion Criteria:\n\n* Previous history of liver transplantation\n* Imaging or gastroscopy findings indicated ulcers or other causes of gastrointestinal bleeding\n* Concurrent severe life-threatening diseases involving the circulatory, hematological, or respiratory systems\n* Difficulty in follow-up, or lack of essential medical history information, imaging data, or other necessary records",{"count":435,"type":22},1066,"This study aims to evaluate the impact of high-risk factors-such as elevated portal venous pressure, concurrent large extra-luminal vessels, portal vein thrombosis, and prominent portosystemic shunts-on the efficacy of endoscopic therapy. By comparing with interventional treatment, the goal is to optimize the clinical management protocol for esophageal and gastric varices, enhance the therapeutic outcomes of portal hypertension-related esophageal and gastric varices, and improve patient prognosis.",[30,438,29,234],"Gastroesophageal Varices Hemorrhage","2026-03-24",{"date":441,"type":45},"2026-03-31",{"date":443,"type":22},"2026-03-17",{"date":445,"type":22},"2027-12-31",{"name":198,"class":52},{"id":448,"slug":449,"hasResults":12,"nctId":450,"briefTitle":451,"officialTitle":452,"acronym":4,"eligibilityCriteria":453,"healthyVolunteers":12,"sex":18,"minAge":4,"maxAge":19,"enrollmentInfo":454,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":456,"conditions":457,"keywords":4,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":458,"lastUpdatePostDateStruct":459,"startDateStruct":461,"completionDateStruct":463,"leadSponsor":465,"locationsCount":4},"100628659","non-invasive-predictors-of-esophageal-varices-and-their-correlation-to-upper-endoscopic-findings-100628659","NCT07464522","Non-invasive Predictors of Esophageal Varices and Their Correlation to Upper Endoscopic Findings","Non-invasive Predictors of Esophageal Varices in Pediatric Portal Hypertension and Their Correlation to Upper Endoscopic Findings","Inclusion Criteria:\n\n* Patients aged less than 18 years diagnosed with portal hypertension either due to hepatic or extrahepatic causes\n\nExclusion Criteria:\n\n* Active variceal bleeding at presentation (hemodynamic instability affects platelet\u002Fspleen parameters).\n* Previous history of variceal bleeding or endoscopic intervention (band ligation\u002Fsclerotherapy).\n* Prior surgical portosystemic shunts or Transjugular Intrahepatic Portosystemic Shunt (TIPS).\n* Current use of vasoactive drugs for primary prophylaxis (e.g., Non-selective beta-blockers).\n* Systemic infections or hematological disorders causing independent thrombocytopenia or splenomegaly (to avoid confounding the platelet\u002Fspleen ratio).",{"count":455,"type":22},51,"The goal of this observational study:\n\n* To evaluate the diagnostic accuracy of non-invasive markers in predicting the presence and grading of esophageal varices in children with portal hypertension.\n* To correlate these non-invasive markers with the severity of portal hypertension and the grade of esophageal varices to identify patients at high risk of bleeding.\n* To propose a defined protocol for screening esophageal varices in those children.",[234,30],"2026-03-19",{"date":460,"type":45},"2026-03-23",{"date":462,"type":22},"2026-03-20",{"date":464,"type":22},"2028-05-20",{"name":277,"class":52},{"id":467,"slug":468,"hasResults":12,"nctId":469,"briefTitle":470,"officialTitle":471,"acronym":4,"eligibilityCriteria":472,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":227,"enrollmentInfo":473,"targetDuration":4,"studyType":23,"phases":474,"briefSummary":477,"conditions":478,"keywords":479,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":458,"lastUpdatePostDateStruct":482,"startDateStruct":483,"completionDateStruct":485,"leadSponsor":487,"locationsCount":53},"100411118","phase-1-eus-guided-portal-systemic-pressure-gradient-measurement-100411118","NCT04633356","EUS Guided Portal-systemic Pressure Gradient Measurement","EUS Guided Portal-systemic Pressure Gradient Measurement in Patients With Chronic Hepatitis.","Inclusion Criteria:\n\n* Suffering from chronic hepatitis induced cirrhosis\n* Informed consent available\n\nExclusion Criteria:\n\n* Medical\n* Child-Pugh Class C\n* Uncorrected platelet count \\\u003C50,000\n* INR \\> 1.5 (natural)\n* Anatomical\n* Previous transjugular intrahepatic or surgical portosystemic shunt\n* Portal vein thrombosis\n* Anatomic alterations of the hepatic vasculature that prevent access to the portal vein or intrahepatic portion of the hepatic veins (identified at screening and\u002For during the endoscopic procedure).\n* Previous history of spontaneous bacterial peritonitis within the previous three months\n* Portopulmonary hypertension\n* Cardiac decompensation\n* Endoscopically Confirmed Exclusion Criteria\n* Evidence of active GI bleeding (identified at screening and\u002For during the endoscopic procedure)\n* If the volume of ascites in the path of the needle prevents apposition of the gastrointestinal tract and liver.\n* Presence of gastric or duodenal ulcers, dieulafoy's lesion or cancers.",{"count":154,"type":22},[475,476],"PHASE1","PHASE2","Portal hypertension is characterised by an increased portal pressure gradient (PPG), that is the difference in pressure between the portal vein and the inferior vena cava (IVC). Portal hypertension is a consequence of cirrhosis resulting from chronic hepatitis. Patients with portal hypertension are at risk of developing complications including oesophageal or gastric varices, variceal bleeding, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy and mortality.\n\nAlbeit its clinical significance, direct measurement of portal venous pressure to document portal hypertension has traditionally been difficult. The portal vein pressure can be measured by transhepatic or transvenous methods but the procedure carries a risk of intra-peritoneal bleeding. Furthermore, the IVC pressure measurement requires further transjugular catheterisation. Hence, the technique is rarely used. Currently, the gold standard in measurement of portal hypertension is via measurement hepatic venous pressure gradient (HVPG). The HVPG has been shown to correlate with risk of clinical decompensation, development of varices, hepatocellular carcinoma, variceal bleeding, spontaneous bacterial peritonitis and mortality. Nevertheless, the technique has a low acceptance rate amongst patients and it may not be available even in tertiary medical centres.\n\nRecently, the use of EUS-guided approach for measurement of portal pressure gradient (PPGM) has been shown to be feasible. The technical success rate was 100% and no adverse events were reported. Measurements obtained with the EUS approach was shown to correlate excellently with clinical parameters of portal hypertension including presence of varices, portal hypertensive gastropathy and thrombocytopenia. Furthermore, the procedure could be performed at the same time of screening oesophagogastroduodenoscopy (OGD), that is frequently required for variceal screening in this group of patients. Hence, the aim of the current study is to investigate the feasibility of EUS-PPGM and correlate the risk of developing complications with the PPGM in patients that are suffering from chronic hepatitis.",[30,67],[190,480,481,67],"portal pressure gradient","EUS interventions",{"date":462,"type":45},{"date":484,"type":45},"2020-11-12",{"date":486,"type":22},"2026-11-11",{"name":488,"class":52},"Chinese University of Hong Kong",{"id":490,"slug":491,"hasResults":12,"nctId":492,"briefTitle":493,"officialTitle":494,"acronym":495,"eligibilityCriteria":496,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":497,"targetDuration":4,"studyType":23,"phases":498,"briefSummary":499,"conditions":500,"keywords":502,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":508,"lastUpdatePostDateStruct":509,"startDateStruct":511,"completionDateStruct":513,"leadSponsor":515,"locationsCount":53},"100629120","fiber-optic-navigation-during-tips-creation-a-prospective-pilot-study-100629120","NCT07470515","Fiber-Optic Navigation During TIPS Creation: A Prospective Pilot Study","Fiber-Optic Navigation During Transjugular Intrahepatic Portosystemic Shunt Creation: A Prospective Pilot Study Evaluating Procedural Parameters","FLIGHT","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Clinical indication for transjugular intrahepatic portosystemic shunt (TIPS) creation according to standard clinical practice (e.g., refractory ascites or variceal bleeding)\n* Ability to provide written informed consent\n\nExclusion Criteria:\n\n* Inability or unwillingness to provide informed consent\n* Pregnancy or breastfeeding\n* Absolute contraindications to TIPS according to current clinical standards (e.g., severe right heart failure, uncontrolled systemic infection)\n* Participation in another clinical study that may interfere with the results of this study",{"count":154,"type":22},[25],"Transjugular intrahepatic portosystemic shunt (TIPS) creation is an established minimally invasive treatment for complications of portal hypertension such as refractory ascites and variceal bleeding. A technically challenging step of the procedure is the puncture of the portal vein from the hepatic vein, which is usually performed under fluoroscopic guidance and may require multiple puncture attempts.\n\nThis prospective pilot study evaluates the use of fiber-optic navigation technology during TIPS creation. The system allows real-time three-dimensional visualization of guidewires and catheters and may improve spatial orientation during the procedure.\n\nApproximately 30 patients with a clinical indication for TIPS placement will be included. The study will assess procedural parameters such as the number of puncture attempts, fluoroscopy time, radiation exposure, procedure duration, technical success, and complications.\n\nThe results may help to improve procedural efficiency and radiation safety during TIPS interventions.",[133,501,260,30],"Refractory Ascites",[75,30,503,504,505,506,507],"Interventional Radiology","Fiber-Optic Navigation","Image-Guided Intervention","Endovascular Navigation","Radiation Reduction","2026-03-10",{"date":510,"type":45},"2026-03-13",{"date":512,"type":22},"2027-01",{"date":514,"type":22},"2028-12",{"name":516,"class":52},"Medical University Innsbruck",{"id":518,"slug":519,"hasResults":12,"nctId":520,"briefTitle":521,"officialTitle":522,"acronym":523,"eligibilityCriteria":524,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":227,"enrollmentInfo":525,"targetDuration":4,"studyType":23,"phases":527,"briefSummary":528,"conditions":529,"keywords":532,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":534,"lastUpdatePostDateStruct":535,"startDateStruct":537,"completionDateStruct":539,"leadSponsor":540,"locationsCount":542},"100625617","hepatic-venous-pressure-gradient-versus-endoscopic-ultrasound-guided-portal-pressure-gradient---comparative-analysis-hepca-100625617","NCT07424963","Hepatic Venous Pressure Gradient Versus Endoscopic Ultrasound-Guided Portal Pressure Gradient - Comparative Analysis (HEPCA)","Hepatic Venous Pressure Gradient Versus Endoscopic Ultrasound-Guided Portal Pressure Gradient - Comparative Analysis","HEPCA","Inclusion Criteria:\n\n* Age 18-75 years at the time of enrollment; signed informed consent\n* Clinical indication for HVPG measurement and\u002For transjugular liver biopsy for chronic advanced liver disease\n\nExclusion Criteria:\n\n* Severe co-morbidities (e.g., advanced chronic heart failure, chronic renal insufficiency stage 4 and above, long-term poorly compensated diabetes mellitus with severe complications)\n* Pregnancy\n* Estimated patient non-compliance and\u002For not signing of the informed consent\n* Documented iodine contrast dye allergy\n* Presence of portal vein thrombosis or cavernomatous transformation of portal vein or hepatic vein obstruction\n* Ascites Grade 3\n* Biliary obstruction\n* Anticoagulation or antiplatelet therapy, which cannot be discontinued\n* INR \\> 1.5 and\u002For platelet count \\\u003C 50,000\u002Fµl\n* Hepatocellular carcinoma in the left lobe of the liver\n* Surgically altered upper gastrointestinal tract anatomy\n* State after transjugular intrahepatic portosystemic shunt\n* State after liver transplantation",{"count":526,"type":22},40,[25],"The goal of this interventional trial is to compare in measuring of portal hypertension by HVPG and EUS-PPG in subject indicated to HVPG measurement.\n\nThe primary question is whether EUS-PPG provides measurements really equivalent to HVPG in terms of gradient accuracy.\n\nParticipants undergoing HVPG will first undergo the procedure while conscious, performed by the first operator. Immediately thereafter, HVPG will be repeated following the induction of anesthesia by a second operator blinded to the initial readings. Subsequently, EUS-PPG will be performed by an endoscopist, who will also be blinded to all previous pressure measurements.",[67,30,530,346,531,70],"EUS","HVPG",[531,533,190,322],"EUS-PPG","2026-02-16",{"date":536,"type":45},"2026-02-20",{"date":538,"type":45},"2025-05-30",{"date":196,"type":22},{"name":541,"class":52},"Military University Hospital, Prague",2,{"id":544,"slug":545,"hasResults":12,"nctId":546,"briefTitle":547,"officialTitle":548,"acronym":4,"eligibilityCriteria":549,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":550,"targetDuration":552,"studyType":96,"phases":4,"briefSummary":553,"conditions":554,"keywords":4,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":555,"lastUpdatePostDateStruct":556,"startDateStruct":558,"completionDateStruct":560,"leadSponsor":562,"locationsCount":53},"100625214","construction-of-a-portal-hypertension-biobank-100625214","NCT07419724","Construction of a Portal Hypertension Biobank","Construction of a Biobank for a Specialized Cohort of Portal Hypertension","Inclusion Criteria:\n\n1. Clinically diagnosed with portal hypertension complicated by esophagogastric varices.\n2. Underwent abdominal CT examination\n\nExclusion Criteria:\n\n1. Imaging or endoscopic evidence demonstrating absence of esophageal and\u002For gastric varices.\n2. CT image quality not meeting requirements or incomplete medical history data.",{"count":551,"type":22},1000,"3 Years","Esophageal and gastric variceal bleeding (EGVB) is a severe complication of portal hypertension (PH), characterized by high bleeding volume, high rebleeding rate, and high mortality. In recent years, endoscopic treatment has significantly improved therapeutic efficacy and patient survival. However, due to substantial individual variations among patients, individualized stratified management is crucial. For special populations with cirrhotic portal hypertension, clear management guidelines and clinical research evidence are lacking. The incidence of non-cirrhotic portal hypertension is increasing year by year; it has complex etiologies, lacks specific symptoms and imaging features, and poses diagnostic challenges. Currently, multi-omics research on portal hypertension is insufficient. The integration of multi-omics technologies, including genomics, radiomics, metabolomics, and gut microbiota, holds promise for a more comprehensive understanding of the pathogenesis. With continuous improvements in multi-modal medical data fusion technology, there is an urgent need to develop clinical decision support systems by combining standardized multi-omics databases with artificial intelligence techniques, thereby enhancing clinical decision-making capabilities and prognostic assessment.\n\nThis study aims to expand the established portal hypertension biobank by extending the temporal depth of clinical cohort data and diversifying sample types.",[260,30],"2026-02-12",{"date":557,"type":45},"2026-02-19",{"date":559,"type":45},"2025-10-16",{"date":561,"type":22},"2031-12-31",{"name":198,"class":52},{"id":564,"slug":565,"hasResults":12,"nctId":566,"briefTitle":567,"officialTitle":568,"acronym":569,"eligibilityCriteria":570,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":571,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":573,"conditions":574,"keywords":577,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":580,"lastUpdatePostDateStruct":581,"startDateStruct":582,"completionDateStruct":584,"leadSponsor":586,"locationsCount":53},"100624139","cirrhotic-and-non-cirrhotic-patients-with-clinically-significant-portal-hypertension-100624139","NCT07405749","Cirrhotic and Non-cirrhotic Patients With Clinically Significant Portal Hypertension","Incidence and Predictive Factors of Elective Procedure-Related Bleeding in Cirrhotic and Non-Cirrhotic Patients With Clinically Significant Portal Hypertension","PREDIBLEED","Inclusion Criteria:\n\n* Age \\> 18 years;\n* Ability to provide informed consent;\n* Specific signs of CSPH (gastroesophageal varices, porto-systemic collaterals, liver stiffness measurement (LSM) \\> 25 KPa or spleen stiffness measurement (SSM) \\> 50 KPa);\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years;\n* Life expectancy \\\u003C 6 months;\n* Patients unable to sign informed consent.",{"count":572,"type":22},2500,"Alterations in conventional coagulation tests in patients with cirrhosis and\u002For portal hypertension do not reliably predict bleeding risk, as hemostatic balance is complex and often compensated. Many procedure-related bleeding events are driven by non-coagulatory factors, such as portal hypertension or technical aspects of the procedure. Most commonly performed procedures carry a low risk of bleeding even in the presence of elevated INR or thrombocytopenia, and no validated laboratory thresholds support prophylactic correction. Risk assessment should therefore be based on procedural factors, severity of liver disease, and systemic patient conditions, with correction of modifiable risk factors particularly before high-risk elective procedures.",[158,30,575,576],"Clinically Significant Portal Hypertension(CSPH)","Gastroesophageal Varices",[578,579],"Thrombotic events","porto-systemic collaterals","2026-02-05",{"date":555,"type":45},{"date":583,"type":22},"2026-02",{"date":585,"type":22},"2030-02",{"name":587,"class":52},"Fondazione Policlinico Universitario Agostino Gemelli IRCCS",{"id":589,"slug":590,"hasResults":12,"nctId":591,"briefTitle":592,"officialTitle":593,"acronym":4,"eligibilityCriteria":594,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":227,"enrollmentInfo":595,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":597,"conditions":598,"keywords":600,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":580,"lastUpdatePostDateStruct":603,"startDateStruct":605,"completionDateStruct":607,"leadSponsor":609,"locationsCount":53},"100475752","3d-mre-for-assessing-cirrhosis-advanced-chronic-liver-disease-and-portal-hypertension-100475752","NCT05475015","3D-MRE for Assessing Cirrhosis, Advanced Chronic Liver Disease and Portal Hypertension","Three-dimensional MR Elastography for Assessing Cirrhosis and Portal Hypertension (CHESS2206): A Prospective Multicenter Study","Inclusion criteria were: (1) ≥18 years; (2) written informed consent; (3) confirmed ACLD of any liver disease etiology; (4) clinically indicated for HVPG measurement, with 3D-MRE performed within one month prior.\n\nExclusion criteria were: (1) hepatic or extrahepatic malignancies, or large hepatic or splenic focal diseases affecting MRE measurement; (2) MR or HVPG contraindications; (3) prior liver or splenic surgery affecting MRE measurement; (4) treatment with nonselective β-blockers (NSBB) between MRE and HVPG measurements; (5) invalid or unreliable HVPG or MRE results and (6) biliary obstruction or dilation on MR images.",{"count":596,"type":22},150,"How to construct a novel, non-invasive, accurate, and convenient method to achieve prediction of hepatic venous pressure gradient (HVPG) is an important general problem in the management of portal hypertension in cirrhosis or advanced chronic liver disease. We plan to investigate the ability of three demensional-magnetic resonance elastography (3D-MRE) to establish a risk stratification system and perform tailored management for portal hypertension in cirrhosis or advanced chronic liver disease.",[158,30,599],"Advanced Chronic Liver Disease",[601,531,602],"3D-MRE","advanced chronic liver disease",{"date":604,"type":45},"2026-02-09",{"date":606,"type":45},"2022-08-16",{"date":608,"type":22},"2026-12-01",{"name":610,"class":52},"Shengjing Hospital",{"id":612,"slug":613,"hasResults":12,"nctId":614,"briefTitle":615,"officialTitle":616,"acronym":617,"eligibilityCriteria":618,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":619,"targetDuration":4,"studyType":23,"phases":621,"briefSummary":622,"conditions":623,"keywords":4,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":625,"lastUpdatePostDateStruct":626,"startDateStruct":628,"completionDateStruct":630,"leadSponsor":632,"locationsCount":4},"100621060","liver-cirrhosis-complicated-by-clinically-significant-portal-hypertension-100621060","NCT07365709","Liver Cirrhosis Complicated by Clinically Significant Portal Hypertension","Liver Cirrhosis Complicated by Clinically Significant Portal Hypertension: the Role of Contrast-enhanced Ultrasound and Splenic Elastography for Non-invasive Assessment","CIRCE","Inclusion Criteria:\n\nIndividuals of both sexes aged 18 years or over; Subjects diagnosed with liver cirrhosis. Subjects who have undergone hepatic venous pressure gradient (HVPG) measurement to assess portal hypertension, and\u002For show indirect clinical signs of significant portal hypertension, such as oesophageal varices or porto-systemic collateral circulation.\n\nCirrhotic subjects who must undergo contrast-enhanced ultrasound as part of regular hepatological follow-up.\n\nSubjects who have given their informed consent.\n\nExclusion Criteria:\n\nSubjects aged under 18 years; Subjects with cholestatic disease Subjects diagnosed with clinically significant portal hypertension of non-cirrhotic aetiology.\n\nSubjects diagnosed with ascites Subjects diagnosed with splanchnic thrombosis Subjects presenting with spleno-portal flow reversal Subjects who are allergic to ultrasound contrast media Subjects who have not given their informed consent.",{"count":620,"type":22},107,[25],"Portal hypertension is a major complication of cirrhosis. HVPG is the diagnostic gold standard but is invasive. Non-invasive tools such as spleen stiffness measurement (SSM) and CEUS show promise for assessing CSPH, though they have not yet been compared directly. A multimodal ultrasound approach may provide a reliable alternative to HVPG.",[30,624,67],"Spleen Disease","2026-01-16",{"date":627,"type":45},"2026-01-26",{"date":629,"type":22},"2026-02-01",{"date":631,"type":22},"2026-12-31",{"name":587,"class":52},{"id":634,"slug":635,"hasResults":12,"nctId":636,"briefTitle":637,"officialTitle":638,"acronym":639,"eligibilityCriteria":640,"healthyVolunteers":12,"sex":18,"minAge":19,"maxAge":152,"enrollmentInfo":641,"targetDuration":4,"studyType":23,"phases":642,"briefSummary":643,"conditions":644,"keywords":4,"overallStatus":41,"whyStopped":4,"lastUpdateSubmitDate":646,"lastUpdatePostDateStruct":647,"startDateStruct":649,"completionDateStruct":650,"leadSponsor":652,"locationsCount":4},"100620220","the-feasibility-safety-and-efficacy-of-eus-guided-pse-a-cohort-study-100620220","NCT07354789","The Feasibility, Safety, and Efficacy of EUS-Guided PSE: A Cohort Study","The Feasibility, Safety and Efficacy of Endoscopic Ultrasound (EUS) Guided Partial Splenic Embolization(PSE): A Cohort Study","EUS; PSE","Inclusion Criteria:\n\n1. Aged 18-80 years.\n2. Diagnosis of liver cirrhosis based on clinical, laboratory, and imaging examinations.\n3. Complicated with gastrointestinal bleeding caused by esophagogastric varices.\n4. Patients with hypersplenism and thrombocytopenia (platelet count \\\u003C 100 × 10\\^9\u002FL).\n\nExclusion Criteria:\n\n1. Patients who have previously undergone splenectomy, PSE, transjugular intrahepatic portosystemic shunt (TIPS), varicocelectomy, sclerotherapy, or balloon-occluded retrograde transvenous obliteration.\n2. Hepatocellular carcinoma or other malignant tumors.\n3. Patients with hepatic encephalopathy who are unable to cooperate, or those with liver failure or a Child-Pugh score \\>13.\n4. Patients with allergies to intravenous anesthetics.\n5. Patients with unstable vital signs, associated organ dysfunction, active infection, or cardiopulmonary insufficiency, who cannot tolerate endoscopy.\n6. Patients who are unable or unwilling to provide informed consent.\n7. Uncorrectable coagulation disorders (INR \\>1.5 and\u002For fibrinogen \\\u003C120 mg\u002FdL) or uncorrectable thrombocytopenia (platelet count \\\u003C20 × 10\\^9\u002FL).\n8. Patients who have used beta-blockers within the past 24 hours",{"count":287,"type":22},[25],"Bleeding from esophagogastric varices in patients with liver cirrhosis is often life-threatening. Thrombocytopenia caused by hypersplenism secondary to portal hypertension is an independent risk factor for such gastrointestinal bleeding. Studies have confirmed that partial splenic embolization (PSE) can effectively reduce portal pressure and decrease the risk of rebleeding.\n\nTraditional treatments mainly include total splenectomy and X-ray-guided transarterial partial splenic embolization (X-PSE). Although total splenectomy can completely remove the lesion, its application is limited by issues such as increased risks of postoperative infection, thrombosis, and long-term immune dysfunction. Currently, X-PSE has become the mainstream treatment. This technique involves superselective catheterization of the splenic artery branches using a microcatheter and injecting embolic microspheres to achieve partial splenic embolization, thereby preserving partial splenic function. However, X-PSE relies on radiological intervention techniques and carries risks such as radiation exposure, contrast-induced nephropathy, and non-target embolization (e.g., pancreatic necrosis). Additionally, its ability to locate small arterial branches in the splenic hilum is limited.\n\nEndoscopic ultrasound (EUS) integrates an ultrasound probe at the tip of an endoscope, enabling high-resolution imaging and fine-needle aspiration therapy of the pancreas, gastrointestinal tract, posterior mediastinum, and retroperitoneal structures. With color Doppler functionality, EUS can clearly identify abdominal vessels and their blood flow signals. Since the spleen and splenic vessels are located posterior to the gastric fundus, EUS can clearly visualize the vascular structures of the splenic hilum via a transgastric approach.\n\nCompared to X-PSE, EUS-guided PSE offers the following advantages: a shorter puncture path; avoidance of iodinated contrast agents, making it suitable for patients with iodine allergies or renal insufficiency; no X-ray exposure for patients or operators; the ability to combine treatment for esophagogastric varices in the same procedure, thereby simplifying the process, reducing costs, and shortening hospital stays; and, since there is no arterial puncture site on the body surface, patients do not require prolonged limb immobilization postoperatively, resulting in an overall better healthcare experience.\n\nCurrent literature and small-sample retrospective studies have reported on this technique, but the included cases are mostly limited to patients with mild liver function impairment, and there is a lack of systematic evaluation of its effect on portal pressure reduction.\n\nThe investigators' center integrates the advantages of EUS and X-PSE to perform EUS-guided transgastric puncture for precise injection of embolic materials into the splenic artery branches in patients with liver cirrhosis, gastrointestinal bleeding, and hypersplenism, achieving partial splenic embolization. This study aims to evaluate the safety and efficacy of EUS-guided PSE. The primary endpoint is safety, including the incidence of complications such as intraoperative bleeding, postoperative fever, and abdominal pain scores. Secondary endpoints include efficacy indicators: platelet count, portal pressure gradient, embolization area on CT, incidence of gastrointestinal rebleeding, as well as hospitalization costs and length of stay.",[67,30,645],"Bleeding","2026-01-12",{"date":648,"type":45},"2026-01-21",{"date":194,"type":22},{"date":651,"type":22},"2027-03-15",{"name":653,"class":52},"Qilu Hospital of Shandong University",{"id":655,"slug":656,"hasResults":12,"nctId":657,"briefTitle":658,"officialTitle":658,"acronym":4,"eligibilityCriteria":659,"healthyVolunteers":660,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":661,"targetDuration":4,"studyType":23,"phases":663,"briefSummary":664,"conditions":665,"keywords":4,"overallStatus":107,"whyStopped":4,"lastUpdateSubmitDate":666,"lastUpdatePostDateStruct":667,"startDateStruct":669,"completionDateStruct":671,"leadSponsor":673,"locationsCount":542},"100601868","effect-of-handgrip-strength-on-portal-vein-hemodynamics-in-patients-with-liver-cirrhosis-100601868","NCT07116096","Effect of Handgrip Strength on Portal Vein Hemodynamics in Patients With Liver Cirrhosis","Inclusion Criteria:\n\n* Adults aged ≥18 years old\n* Clinically diagnosed with liver cirrhosis\n* Endoscopic observation to determine the presence of esophagogastric varices\n* Only eligible for the portal vein pressure measurement group if there are no signs of variceal bleeding for at least 14 days\n* Participant or guardian is capable of comprehending the study protocol, willing to participate, and able to provide written informed consent\n\nExclusion Criteria:\n\n* Severe congestive heart failure, or severe untreated valvular heart disease\n* Moderate to severe pulmonary hypertension\n* Uncontrolled systemic infection\n* Lesions (e.g., cysts) or tumors in the liver parenchyma that preclude TIPS creation\n* Overt hepatic encephalopathy\n* Unrelieved biliary obstruction\n* Child-Pugh score \\> 13\n* MELD score \\> 18\n* INR \\> 5\n* Platelet count \\\u003C 20 ×109\u002Fmm3\n* No gastrointestinal bleeding (suitable for the ultrasound examination group and the endoscopic ultrasonography group)\n* Participants who had undergone hand or wrist surgery within the previous 3 months or were unable to hold the dynamometer with the testing hand were excluded from the study.",true,{"count":662,"type":22},120,[25],"1. Background Handgrip strength , a core indicator of muscle function, has been confirmed to be significantly associated with the clinical prognosis of patients with liver cirrhosis. However, no studies have explored its correlation with portal venous hemodynamics.\n2. Objective The purpose of the study is to examine the effects of Handgrip strength on portal vein and left gastric vein pressure, blood flow velocity and direction in patients with liver cirrhosis, as well as its hemodynamic impact on gastroesophageal varices.\n3. Method Study Design: Interventional study. Detection Timing: Hemodynamic indices were measured simultaneously after patients achieved their maximum handgrip strength. Participants were divided into three groups based on the assessment methods. Group 1 (Portal Pressure Measurement Group): Before the placement of TIPS, the pressures of the portal vein and left gastric vein were measured, both before and after the handgrip strength test. Group 2 (Doppler Ultrasound Measurement Group): Measurements of portal flow velocity and direction were taken before and after the handgrip strength test, based on Doppler ultrasound. Group 3 (Endoscopic Ultrasound Measurement Group): Measurements of blood flow volume and direction in esophagogastric varices were conducted before and after the handgrip strength test, based on endoscopic ultrasonography. The inclusion and exclusion criteria were described.\n4. Elaboration of the Research Hypothesis 4.1. Core Hypothesis The handgrip strength level in patients with liver cirrhosis is correlated with portal venous system hemodynamic indices. Specifically, enhanced handgrip strength may affect portal hypertension and the hemodynamics of varicose veins by improving systemic muscle function or circulatory status.\n\n4.2. Speculation on potential mechanisms Association between muscle function and circulation: As a representative of systemic muscle function, increased handgrip strength may reflect an increase in cardiac output or changes in splanchnic vascular resistance, thereby influencing portal venous hemodynamics.\n\nEffects on varicose veins: Improved handgrip strength may reduce blood flow velocity or diameter of esophagogastric varices by decreasing splanchnic congestion or regulating local vascular tension, thus lowering the risk of variceal rupture and bleeding.\n\nRole of compensatory mechanisms: Muscle wasting is common in decompensated cirrhosis. Patients with higher handgrip strength may have better compensatory capacity, and the degree of hemodynamic disorder in their portal venous system may be less severe.\n\nConclusion This study uses a multi-method grouping design to first explore the association between handgrip strength and portal venous hemodynamics in cirrhotic patients. The hypothesis is based on the potential regulatory role of muscle function in the circulatory system, which is expected to provide a new non-invasive indicator for clinical assessment of portal hypertension risk.",[133,30],"2026-01-11",{"date":668,"type":45},"2026-01-13",{"date":670,"type":45},"2025-08-17",{"date":672,"type":22},"2026-08-15",{"name":674,"class":675},"Shanxi Provincial People's Hospital","OTHER_GOV"]