Portal Hypertension
Conditions
Keywords
Transjugular Intrahepatic Portosystemic Shunt, TIPS, cirrhosis, hepatitis, portal vein thrombosis, Budd-Chiari Disease, Elastography
Brief summary
The primary purpose of this project is to determine if acute monitoring of shunt patency via ultrasound elastography measurements of splenic stiffness before and after TIPS placement results in reduced morbidity and mortality from shunt failure.
Detailed description
Portal hypertension is a condition that is caused by various disorders of the liver, including cirrhosis, hepatitis, portal vein thrombosis, or Budd-Chiari Disease. Portal hypertension can lead to the accumulation of fluid in the abdomen, called ascites, or put patients at risk for bleeding of the esophagus, stomach, and bowel. In certain patients, portal hypertension is treated by placement of a Transjugular Intrahepatic Portosystemic Shunt (TIPS). Elastography is a newer exam which measures the consistency, or softness/stiffness, of various organs in the body. It is performed with ultrasound by sliding a transducer across the abdomen. Elastography is most commonly used to evaluate the liver, as disorders that cause damage to the liver result in stiffer liver tissue. The spleen has also been shown to get stiffer in the setting of portal hypertension.
Interventions
The TIPS procedures creates an artificial shunt from the portal vein to the hepatic vein. TIPS allows blood from the congested portal circulation to bypass the fibrotic liver and directly enter the systemic circulation.
Sponsors
University of Kansas Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients who undergo TIPS placement at the University of Kansas Medical Center (KUMC) are eligible for participation in this study
Exclusion criteria
* Patients under 18 years of age * Patients with prior splenectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spleen stiffness | Change from Baseline to 2 weeks post-procedure | The spleen stiffness will be measured before and after TIPS placement. Spleen stiffness is measured using US elastography and is reported in m/sec. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in spleen stiffness | Change from Baseline to Month 12 | The spleen stiffness will be measured before and after TIPS placement. Spleen stiffness is measured using US elastography and is reported in m/sec. |
Countries
United States
Outcome results
None listed