Study of Underdilated Balloon Technique During TIPS to Reduce Postoperative Hepatic Encephalopathy in Adults With Liver Cirrhosis

What this Trial Is About

Researchers are evaluating the use of an underdilated-stent technique during transjugular intrahepatic portosystemic shunt TIPS procedures to reduce the occurrence of hepatic encephalopathy HE in patients with decompensated liver cirrhosis. HE is a common complication after TIPS, especially within the first 3 to 6 months. Current treatments like lactulose and rifaximin have not been proven to effectively prevent HE after TIPS, and previous studies on underdilated strategies lack high-quality evidence. The study compares two approaches during TIPS one group receives an underdilated strategy using a 6mm balloon to dilate the puncture tract before implanting an 8mm Viatorr stent, which allows the stent to expand gradually over months the other group receives a fully-dilated strategy with an 8mm balloon and an 8mm stent implanted immediately. This randomized controlled trial aims to see if the underdilated method lowers post-TIPS HE without reducing treatment effectiveness for portal hypertension complications. Participants will be monitored for 12 months after the procedure, with researchers assessing the incidence of overt hepatic encephalopathy, remission of portal hypertension complications, liver function, and survival without liver transplantation. The study involves regular evaluations to track these outcomes and ensure patient safety. This long-term follow-up will help determine if the underdilated technique offers benefits in managing complications after TIPS.

Underdilated-stent Technique Improves Post-TIPS Encephalopathy