- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00735358
Comparison of Endoscopic Injection of Conventional and Double Doses Cyanoacrylate for Gastric Variceal Hemorrhage
October 4, 2010 updated by: Taipei Veterans General Hospital, Taiwan
The recent practice guideline recommends endoscopic injection of cyanoacrylate (GVO) is the preferred method to treat acute gastric variceal bleeding.
The rebleeding rate remains high following GVO.We hypothesized that a double-dose of cyanoacrylate may obliterate the varices more effectively and achieve better hemostasis.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Although outcome of variceal hemorrhage has been improved in the last two decades, variceal hemorrhage is still the most serious complication of portal hypertension and chronic liver disease.
Occurrence of gastric varices (GV) rupture is less often than esophageal varices (EV) but it is characteristic of higher rebleeding rate and mortality and represents an even tougher problem than EV hemorrhage.
Facing these challenges, there is no consensus on the best treatment of GV hemorrhage and therefore it is mainly empirical.
Endoscopic treatment is an alternative in the management of GVH.
Injection sclerotherapy has been applied to arrest GV hemorrhage but it is associated with a high rebleeding rate (50~90%) and thus is regarded as only a temporary hemostatic measure.
The advantage of endoscopic variceal ligation for EV hemorrhage has been documented, however, endoscopic variceal ligation for GVH is not as promising because of its high rebleeding rate around 50%.
Endoscopic injection of N-butyl-2-cyanoacrylate, a so-called "tissue glue", was more effective for GV hemorrhage than other sclerosants and endoscopic ligation, however, its rebleeding rate is still high around 30~50%.
The theoretical advantages of tissue glue derives from its unique ability to plug the varix lumen immediately.
Each injection of tissue glue in conventional use was usually prepared by a mixture of 0.5 ml cyanoacrylate and 0.5 ml Lipiodol.
Therefore, we hypothesized that double dose cyanoacrylate (1 ml cyanoacrylate mixed with 1 ml Lipiodal) may obliterate the varices in further distance and broader area and that may achieve more effective hemostatic results than conventional dose.
Therefore we designed a randomized trial to test the hypothesis.
Study Type
Interventional
Enrollment (Actual)
105
Phase
- Phase 4
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 78 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients with liver cirrhosis and/or hepatoma
- Aged 18 to 80, who had endoscopy-proven acute GVB
- Clinical signs of hematemesis, coffee ground vomitus, hematochezia, or melena
- Endoscopic signs of active bleeding from the GV
- Adherent blood clots, white nipple signs, or erosions on the GV
- The presence of distinct large GV with red-color signs and absence of EV and other bleeding sources
- Who or their legally authorized representatives gave informed consent
Exclusion Criteria:
- Patients had previous endoscopic, surgical treatment or transjugular intrahepatic portosystemic shunt (TIPS) for GVB
- Had a terminal illness of any major organ system, such as heart failure, uremia, chronic pulmonary disease, or non-hepatic malignancy.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: A
Single dose cyanoacrylate in one shot
|
Cyanoacrylate 0.5 ml, endoscopic injection of gastric varix at each shot
Cyanoacrylate 1 ml, endoscopic injection for gastric varices at each shot
|
Experimental: B
Double doses cyanoacrylate in one shot
|
Cyanoacrylate 0.5 ml, endoscopic injection of gastric varix at each shot
Cyanoacrylate 1 ml, endoscopic injection for gastric varices at each shot
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rebleeding
Time Frame: 2 year
|
2 year
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Survival
Time Frame: 2 year
|
2 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2005
Primary Completion (Actual)
August 1, 2007
Study Completion (Actual)
October 1, 2007
Study Registration Dates
First Submitted
August 12, 2008
First Submitted That Met QC Criteria
August 13, 2008
First Posted (Estimate)
August 14, 2008
Study Record Updates
Last Update Posted (Estimate)
October 6, 2010
Last Update Submitted That Met QC Criteria
October 4, 2010
Last Verified
August 1, 2008
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 95DHA0100359
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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