title: Transjugular intrahepatic portosystemic shunt for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Portal vein thrombosis (PVT) increases the risk of variceal rebleeding in liver cirrhosis. However, the strategy for preventing variceal rebleeding in cirrhotic patients with PVT has not been explored. This study aims to evaluate whether the transjugular intrahepatic portosystemic shunt (TIPS) or conventional therapy is preferable for the prevention of variceal rebleeding in liver cirrhosis patients with PVT.
  
  
  METHODS
  This is a randomised controlled trial comparing the safety and efficacy of TIPS versus conventional therapy (ie, endoscopic therapy combined with non-selective β-blockers and anticoagulants) for the prevention of variceal rebleeding in cirrhotic patients with non-tumoral PVT. A total of 50 cirrhotic patients with PVT (thrombus >50% of portal vein lumen occupancy) and a history of variceal bleeding will be stratified according to the Child-Pugh class and degree of PVT, and randomised into the TIPS and conventional therapy groups. The primary objective was to compare the incidence of variceal rebleeding between the two groups. The secondary objectives were to compare the overall mortality, variceal rebleeding-related mortality, portal vein recanalisation and complications between the two groups, and to observe the progression of PVT in patients without portal vein recanalisation.
  
  
  BACKGROUND
  This study was approved by the ethics committee of Xijing hospital (No. 20110224-5), and was registered at ClinicalTrials.gov (NCT01326949). All participants give written informed consent. The first patient was recruited into our study on 4 June 2011. A total of 29 patients were recruited through 5 March 2013 (14 and 15 patients assigned to the TIPS and conventional therapy groups, respectively). If TIPS is superior to conventional therapy for the prevention of variceal rebleeding in cirrhotic patients with PVT, TIPS might be recommended as the first-line therapy in such patients. But a small sample size potentially limits the generalisation of our conclusions.
  
  
  BACKGROUND
  This study was registered at ClinicalTrials.gov on 29 March 2011. The trial registration number is NCT01326949.
  
  
  METHODS
  The first patient was recruited into our study on 4 June 2011. A total of 29 patients were recruited through 5 March 2013 (14 and 15 patients assigned to the TIPS and conventional therapy groups, respectively).
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Xingshun
authors.initials: X
authors.lastname: Qi
authors.forename: Chuangye
authors.initials: C
authors.lastname: He
authors.forename: Zhanxin
authors.initials: Z
authors.lastname: Yin
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Wang
authors.forename: Hongbo
authors.initials: H
authors.lastname: Zhang
authors.forename: Liping
authors.initials: L
authors.lastname: Yao
authors.forename: Jianhong
authors.initials: J
authors.lastname: Wang
authors.forename: Jielai
authors.initials: J
authors.lastname: Xia
authors.forename: Hongwei
authors.initials: H
authors.lastname: Cai
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Yang
authors.forename: Ming
authors.initials: M
authors.lastname: Bai
authors.forename: Wengang
authors.initials: W
authors.lastname: Guo
authors.forename: Jing
authors.initials: J
authors.lastname: Niu
authors.forename: Kaichun
authors.initials: K
authors.lastname: Wu
authors.forename: Daiming
authors.initials: D
authors.lastname: Fan
authors.forename: Guohong
authors.initials: G
authors.lastname: Han