Transjugular intrahepatic portosystemic shunt insertion in hepatic patients on the haemodynamics - Trial PACTR201807337809744

Timeline & Enrollment

Summary

Transjugular intrahepatic portosystemic shunt (TIPSS) is indicated for patients with cirrhosis complicated by refractory bleeding varices and refractory ascites. TIPS is considered a definitive treatment of portal hypertension caused by cirrhosis. On the successful insertion of the shunt a dramatic reduction in portal pressure is expected and this will effectively help in the management of recurrent variceal haemorrhage and refractory ascites.Portal decompression, through TIPS leads to introduction into the systemic circulation of further blood volumes from the congested portal circulation this is expected to lead to a further increase in cardiac output and vasodilatation to accommodate this acute increase, the ability of patients to respond will vary according to each patient general status and cardiac functions. Monitoring these acute changes can help to early diagnose dysfunctions and support the circulation when required. The primary aim is to investigate the changes in systemic and portal circulations and identify the haemodynamic changes associating the insertion of TIPS. secondary aim is to identify the ability to predict cut off values of measured parameters to help identify patients at risk prior to the shunt insertion also to Investigate the practicality of electric cardiometry to diagnose and manage these expected changes and finally to report the outcome of TIPS (morbidity and /or mortality) and success rate of insertion.

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