Please select the eligibility criteria that correspond to the clinical trial below.
Title: Transjugular Intrahepatic Portosystemic Shunt Versus Endoscopic Treatment Combined With Propranolol for Prevention of Variceal Rebleeding in Cirrhotic Patients With Portal Vein Thrombosis: A Randomized Controlled Trial
Brief Summary: Portal vein thrombosis (PVT) refers to an obstruction in the trunk of the portal vein. It can extend downstream to the portal branches, or upstream to the splenic and/or the mesenteric veins. The prevalence of PVT is 10-25% and incidence is about 16% in cirrhotic patients. Recent studies demonstrate that the presence of PVT is not only an independent predictor of failure to control active variceal bleeding and prevent variceal rebleeding, but also significantly associated with increased mortality in patients with liver cirrhosis.

However, in recent American Association of the Study of Liver Disease (AASLD) practice guidelines and Baveno V consensus, no treatment strategies in cirrhotic patients with PVT was clearly recommended due to the absence of randomized controlled trials.


Options:
A: Inclusion Criteria:

* Patients with portal hypertension caused by liver cirrhosis who presented with an acute or recent episode of gastroesophageal variceal bleeding and have previously received endoscopic treatments of ligation and cyanoacrylate. Diagnosis of liver cirrhosis or mixed cirrhosis was based on results of liver biopsy or biochemical tests and liver imaging by ultrasonography.
* The extent of the varices range from Moderate to Severe.
* The age of the patients range from 18 to 72 years old.

Exclusion Criteria:

* Patients who had other causes for portal hypertention(CTPV,Budd-Chiari syndrome,etc.)
* Patients with severe systemic disease (renal failure, heart failure,carcinoma other than liver cancer,etc.)
* Patients who had contraindications for ligation,sclerotherapy or cyanoacrylate.
* Patients who have previously received shunt or devascularization operation,TIPS.
* Patients who had portosystemic shunt according to the results of CT scan.
B: Inclusion Criteria:

* Patients between 18 and 80 years old.
* Clinical criteria and/or analytical, ultrasound and/or liver biopsy consistent with the diagnosis of liver cirrhosis.
* Hematemesis or melenas within 7 days prior to study inclusion.
* Variceal bleeding. Endoscopic diagnosis:

  * Active variceal bleeding.
  * Clot or platelet cluster or,
  * Esophageal varices associated to red blood in esophagogastric lumen in the absence of other sources of bleeding.
* Patients with standard treatment for prevention of recurrence of variceal bleeding (EVL+B Blockers,Propanolol).
* Women of childbearing age should have a urine pregnancy test negative for 7 days before commencement of treatment and postmenopausal women must have amenorrhea for at least 12 months to be considered not fertile. Potential childbearing women and men must commit to use adequate contraception prior to joining the study and during it.
* Written informed consent to participate in the study.

Exclusion Criteria:

* Pregnancy or lactation
* Presence multiple hepatocellular carcinoma or only diameter\> 5 cm.
* Renal failure ( Creatinine \> 2 mg/dl)
* Advanced liver disfunction (Child Pugh \> 13 points)
* Contraindication for statins.
* Patients HIV treated with antiretroviral therapy.
* Pre-treatment with portosystemic shunt ( surgical or percutaneous).
* Bleeding due to gastric varices.
* Patients with total portal vein thrombosis or portal cavernomatosis.
* Patients previously treated with endoscopic variceal ligation and B- Blockers (before index episode).
* Patients previously treated with statins ( one month before the study).
C: Inclusion Criteria:

* Written informed consent
* Liver cirrhosis
* Portal vein thrombosis (degree of vessel obstruction \> 50%)
* History of variceal hemorrhage in the past 6 weeks (recent variceal bleeding has been controlled for at least 120 hours)

Exclusion Criteria:

* Uncontrolled active variceal bleeding
* Fibrotic cord of the portal vein
* Prior history of TIPS placement or shunt surgery or endoscopic ban ligation +NSBB
* Concomitant renal insufficiency
* Severe cardiopulmonary diseases
* Uncontrolled systemic infection or sepsis
* Malignancy or other serious medical illness which may reduce the life expectancy
* Contraindications for propranolol, such as asthma, insulin-dependent diabetes (with episodes of hypoglycemia), and peripheral vascular disease
* Contraindications for heparin or warfarin
* Contraindications for TIPS
D: Inclusion Criteria:

* All patients with UGI bleeding who are shown to have the findings of cirrhosis and esophagogastric varices or portal hypertensive gastropathy and require 2 or more units of blood transfusion will be included.

Exclusion Criteria:

* None

Answer: C