Anticoagulants and Bleeding Disorders, Gastric Varices Bleeding, Tissue Adhesion
Conditions
Keywords
anticoagulants, tissue glue, gastric varices
Brief summary
This study aimed to clarify the safety of anticoagulant therapy after glue injection for cirrhotic variceal bleeding patients with portal vein thrombosis.
Detailed description
Acute esophagogastric varices bleeding is a common gastroenterological emergency. And the bleeding from ruptured gastric varices is massive and difficulty to stop, even after aggressive pharmacological and conservative treatment. Even after aggressive pharmacological and conservative treatment, maintaining patients without bleeding for a long time is still a challenging clinical problem. Endoscopic tissue adhesive injection is recommended by many international guidelines for acute hemostasis and secondary prevention of gastric variceal bleeding. However, postoperative glue extrusion is inevitable, and the the rebleeding caused by glue ulcers is a problem that is often faced in clinical work. In patients with portal vein thrombosis, the need for anticoagulation and the choice of anticoagulant drugs need to be carefully evaluated in terms of risk and benefit, as the dual conflicts of thrombosis and anticoagulation are involved. At present, there is no in-depth study or consensus on the effect of anticoagulation on rebleeding after glue injection in patients with portal vein thrombosis. This study is of great significance for the treatment and prognosis of patients with gastric varices combined with portal vein thrombosis.
Interventions
DRUGLow molecular weight heparin
Anticoagulants were given. When using warfarin, international normalized ratio (INR) was detected every 3-4 days and adjusted carefully by 0.75mg dosage until achieve the target level of 2-3.
Sponsors
Shandong Provincial Hospital
Taian City Central Hospital
Qilu Hospital of Shandong University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* clinical diagnosis of cirrhosis * Portal hypertension with gastric varices * diagnosis of PVT by imaging examination * undergo glue injection for gastric varices
Exclusion criteria
* hepatocellular carcinoma or other extrahepatic malignancy * isolated portal cavernoma * treatment with TIPS, thrombolysis, thrombectomy or liver transplantation * previous long-term anticoagulation therapy for various reasons * pregnant women * previous endoscopic treatment of GVs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the incidence of a bleeding episode from glue cast extrusion | 6-month | hematemesis, melena, or a ≥ 2 g drop in hemoglobin, with endoscopy-confirmed active spurting or oozing from the site of extrusion of glue casts, or an ulcer with an adherent clot or a visible vessel and no other sources of bleeding |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| death | 6-month | death from all causes of illness related to liver dysfunction |
Countries
China
Contacts
Primary ContactYanjing Gao, PhD.
Backup ContactYunqing Zeng, PhD.
Outcome results
None listed