Esophageal Varices, Portal Hypertension
Conditions
Keywords
Endoscopic Treatment
Brief summary
Endoscopic esophageal variceal ligation combined with gastric variceal embolization using tissue glue is currently the first-choice method for preventing rebleeding in patients with cirrhosis and portal hypertension. However, the rebleeding rate remains relatively high. Factors such as extra-luminal vascular bundles in the esophagus and stomach walls, and portosystemic shunts significantly affect the therapeutic outcomes. Therefore, there is an urgent need to develop an individualized treatment model for esophagogastric varices based on the anatomical and hemodynamic characteristics of the varices, to stratify patient risks and provide tailored treatment options. Before the treatment of esophagogastric varices, the vascular characteristics of esophagogastric varices are assessed based on imaging data such as portal venous CT and ultrasound, as well as clinical information. Risk factors influencing bleeding from esophagogastric varices are explored, and an endoscopic and interventional variceal stratification and treatment model is constructed to provide patients with personalized options for endoscopic or interventional therapy. During the treatment of esophagogastric varices, precise endovascular embolization of the source branch vessels of esophagogastric varices is performed based on hemodynamic models. The safety and efficacy of this treatment strategy are verified through randomized controlled clinical trials. After the treatment of esophagogastric varices, the feasibility of reducing the risk of rebleeding in patients with poor endoscopic outcomes is examined by using drugs that lower portal venous pressure, such as carvedilol or novel oral anticoagulants. Factors influencing recompensation and reversal of portal hypertension are also clarified.
Interventions
None listed
Sponsors
Shanghai Zhongshan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Confirmed diagnosis of portal hypertension; 2. Underwent imaging and endoscopic examination or treatment within one week after admission; 3. Endoscopy revealed the presence of esophageal and/or gastric varices.
Exclusion criteria
1. CT image slice thickness does not meet the requirements or there are artifacts; 2. Endoscopy shows no presence of esophageal and/or gastric varices; 3. Presence of severe life-threatening diseases of the circulatory, hematological, or respiratory systems; 4. Lack of important historical medical information or other relevant data.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gastrointestinal bleeding | 1 year | Gastrointestinal bleeding within 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gastrointestinal bleeding | 6 months, 3 years, and 5 years | Gastrointestinal bleeding within 6 months, 3 years, and 5 years |
| The occurrence of clinical events | 6 months, 1 year, 3 years, and 5 years | The occurrence of events such as ascites progression, overt jaundice, changes in portal vein thrombosis, hepatocellular carcinoma, liver transplantation, or survival and death within 6 months, 1 year, 3 years, and 5 years. |
Countries
China
Contacts
Primary ContactYiting Wang, Ph.D.
Backup Contactxiaoquan huang, M.D.
Outcome results
None listed