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Within-Session Repeatability of EUS-Guided Portal Pressure Gradient Measurement (REPEAT-PPG)

12 novembre 2026 aggiornato da: Prof. Dr. Michael Praktiknjo, University Hospital Muenster

Within-Session Repeatability and Inter-Operator Reproducibility of EUS-Guided Portal Pressure Gradient Measurement: A Prospective Multicentre Study

This prospective multicentre observational reliability study will determine how much a repeated endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement differs from the first measurement in the same patient during the same procedural session. Each participant will undergo two complete EUS-PPG measurement sets using an identical 22-gauge measurement setup. The study will quantify within-session repeatability when the same expert performs both sets and inter-operator reproducibility when different operators perform the sets.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Consecutive adults with an independently established clinical indication for EUS-PPG will be enrolled at five centres. The clinically indicated first measurement will be followed by a research-only second complete measurement set during the same sedation episode, without an intervention between sets. After the first set, the system will be flushed, the needle withdrawn from the liver, the system recalibrated, and the portal and hepatic veins punctured again for fresh triplicate readings. The interval between sets is targeted at 10 minutes or less. Two techniques of withdrawal are allowed. One technique includes transcapsular re-puncture. The needle is flushed and fully retracted from the liver. The other technique includes subcapsular retraction. The needle is flushed and withdrawn into the liver parenchyma to a position immediately beneath the capsule, without crossing it, so that no further capsular puncture is performed. Procedure lists will be cluster-randomised according to examination lists to one of three operator configurations: the same expert performs both sets, two different experts perform the sets, or an expert and a trainee under supervision perform the sets. The order within each pair will be randomised. Clinical decisions will be based exclusively on the first measurement set. Participants will undergo safety follow-up through day 30.

Tipo di studio

Osservativo

Iscrizione (Stimato)

150

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

      • Leuven, Belgio
        • UZ Leuven
        • Contatto:
          • Wim Laleman, MD PhD
    • Quebec
      • Montreal, Quebec, Canada
        • McGill University Health Centre
        • Contatto:
          • Amine Benmassaoud, MD
      • Montreal, Quebec, Canada
        • Centre hospitalier de l'Université de Montréal (CHUM)
        • Contatto:
          • Philippe Willems, MD
    • North Rhine-Westphalia
      • Münster, North Rhine-Westphalia, Germania, 48149
    • Lazio
      • Rome, Lazio, Italia, 00168
        • Fondazione Policlinico Universitario Agostino Gemelli IRCCS
        • Contatto:
          • Francesco Santoapolo, MD

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

Consecutive adult patients with an independently established clinical indication for EUS-guided portal pressure gradient measurement, including patients with and without clinically significant portal hypertension.

Descrizione

Inclusion Criteria:

  • Age 18 years or older
  • Clinical indication for EUS-guided portal pressure gradient measurement established independently of the study
  • Written informed consent, including consent for the additional measurement set

Exclusion Criteria:

  • Contraindication to endoscopy, sedation, or endosonography-guided vascular puncture
  • Non-correctable coagulation disorder
  • Hemodynamic instability at the time of the procedure
  • Any intervention between the two measurement sets that may alter portal pressure, including fluid administration beyond maintenance requirements, vasoactive substances, paracentesis, or variceal band ligation
  • Technically non-evaluable first measurement set
  • Pregnancy or breastfeeding
  • Inability to provide informed consent

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Modelli osservazionali: COHORT
  • Prospettive temporali: PROSPECTIVE

Coorti e interventi

Gruppo / Coorte
Intervento / Trattamento
Same expert operator

Both complete measurement sets are performed by the same expert operator.

During a clinically indicated EUS-PPG procedure, each participant undergoes a second complete EUS-PPG measurement set in the same session. For each set, pressures in a hepatic vein and an intrahepatic portal vein branch are measured in triplicate using the same 22-gauge measurement chain. Before the repeat set, the system is flushed, the needle is withdrawn with one of the allowed techniques, the transducer is recalibrated, and the target vessels are independently re-identified and punctured. No treatment or portal-pressure-altering intervention occurs between the two sets.

Two expert operators

The two complete measurement sets are performed by two different expert operators, with order randomised.

During a clinically indicated EUS-PPG procedure, each participant undergoes a second complete EUS-PPG measurement set in the same session. For each set, pressures in a hepatic vein and an intrahepatic portal vein branch are measured in triplicate using the same 22-gauge measurement chain. Before the repeat set, the system is flushed, the needle is withdrawn with one of the allowed techniques, the transducer is recalibrated, and the target vessels are independently re-identified and punctured. No treatment or portal-pressure-altering intervention occurs between the two sets.

Expert and trainee operators

One complete measurement set is performed by an expert and the other by a trainee under direct supervision, with order randomised.

During a clinically indicated EUS-PPG procedure, each participant undergoes a second complete EUS-PPG measurement set in the same session. For each set, pressures in a hepatic vein and an intrahepatic portal vein branch are measured in triplicate using the same 22-gauge measurement chain. Before the repeat set, the system is flushed, the needle is withdrawn with one of the allowed techniques, the transducer is recalibrated, and the target vessels are independently re-identified and punctured. No treatment or portal-pressure-altering intervention occurs between the two sets.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Within-session repeatability coefficient of EUS-PPG measured by the same expert operator
Lasso di tempo: During the index EUS-PPG procedure

The repeatability coefficient will be calculated as 2.77 multiplied by the within-subject standard deviation of paired EUS-PPG measurements in the same-expert group. It will be reported in mmHg and as a percentage of the cohort mean, with a 95% confidence interval.

During the index EUS-PPG procedure

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Inter-operator reproducibility coefficient of EUS-PPG
Lasso di tempo: During the index EUS-PPG procedure

The reproducibility coefficient will be estimated from paired EUS-PPG differences when different operators perform the two measurement sets and will be reported in mmHg and as a percentage, with a 95% confidence interval.

During the index EUS-PPG procedure
Variance components of repeated EUS-PPG measurements
Lasso di tempo: During the index EUS-PPG procedure

A mixed-effects model using all individual readings will estimate patient-, procedure-list-, operator-, measurement-set-, and reading-level variance components.

During the index EUS-PPG procedure
Intraclass correlation coefficient for paired EUS-PPG measurements
Lasso di tempo: During the index EUS-PPG procedure

Two-way absolute-agreement intraclass correlation coefficients will be reported overall and by operator configuration with 95% confidence intervals.

During the index EUS-PPG procedure
Bland-Altman agreement of paired EUS-PPG measurements
Lasso di tempo: During the index EUS-PPG procedure

Bias and 95% limits of agreement will be calculated overall and separately by operator pairing.

During the index EUS-PPG procedure
Discordant classification at portal pressure gradient thresholds of 10 mmHg and 12 mmHg
Lasso di tempo: During the index EUS-PPG procedure

The proportion of participants whose classification crosses the 10-mmHg or 12-mmHg threshold between the two measurement sets will be reported.

During the index EUS-PPG procedure
Procedure-associated adverse events
Lasso di tempo: From the index procedure through 30 days

Adverse events will include bleeding, pain, hemoglobin decrease, sedation-related events, unplanned admission or prolongation of stay, transfusion, and unplanned intervention.

From the index procedure through 30 days

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Pubblicazioni e link utili

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Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 gennaio 2027

Completamento primario (Stimato)

1 luglio 2028

Completamento dello studio (Stimato)

1 ottobre 2028

Date di iscrizione allo studio

Primo inviato

8 ottobre 2026

Primo inviato che soddisfa i criteri di controllo qualità

8 ottobre 2026

Primo Inserito (Effettivo)

16 ottobre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

13 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

12 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • REPEAT-PPG

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

INDECISO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .