TIPS Combined With Microwave Ablation in HCC Patients With Refractory Ascites
TIPS Combined With Microwave Ablation in HCC Patients With Refractory Ascites
Transjugular intrahepatic portosystemic shunt (TIPS) could effectively decrease portal
 hypertension-related complications. This study intends to evaluate the efficacy and safety of
 TIPS combined with subsequent microwave ablation in HCC patients with refractory ascites.
Hepatocellular carcinoma (HCC) patients with refractory ascites (RA) have a very poor
 prognosis, and there are no effective treatments recommended by the guidelines. TIPS could
 downgrade the ascites and improve Child-Pugh scores. TIPS has been a common management model
 for RA for end-stage liver disease. There is no prospective study evaluating TIPS plus
 thermal ablation. Thus, the investigators carried out this prospective, single-arm study to
 find out it.
Inclusion Criteria:

 1. Age between 18-70 years

 2. Diagnosis of HCC based on the European Association for the Study of the Liver

 3. Tumor diameter ≤ 3cm

 4. Refractory ascites based on International Ascites Club: (a) intensive diuretics
 (spironolactone 400 mg/d combined with furosemide 160 mg/d) and sodium-restricted diet
 (<90 mmoVd) for at least 1 week have no response; (b) lack of response to diuretic
 therapy; (c) early recurrence of ascites within 4 weeks; (d) Diuretic-induced
 complications. The grading of ascites was divided into mild ascites, moderate ascites,
 and large or gross ascites

 Exclusion Criteria:

 1. Congestive heart failure or severe valvular heart failure

 2. Uncontrolled systemic infection or inflammation

 3. Macroscopic vascular invasion or extrahepatic metastasis

 4. Severe pulmonary hypertension

 5. Severe renal insufficiency (except hepatogenic renal insufficiency) (6) rapidly
 progressive liver failure

 6. Diffuse malignant liver tumor

 7. Contrast agent allergy