{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:19:20Z","timestamp":1788499160455,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Large\u2010volume paracentesis is the standard treatment for refractory ascites, but conventional angiocatheter (CA) use may be limited by kinking and dislodgement. KARAHOC (KH) is a multifenestrated over\u2010the\u2010needle catheter with an anchoring disc designed to improve catheter stability. We compared the efficacy and safety of KH with CA in cirrhotic patients with refractory ascites.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This prospective, multicenter, 2\u2009\u00d7\u20092 randomized crossover trial enrolled 87 cirrhotic patients requiring repeated paracentesis at three Korean academic hospitals. Participants underwent paracentesis with both KH and CA in randomized order at least 7\u2009days apart. Successful paracentesis was defined as drainage of \u2265\u20093\u2009L of ascites. Patient and operator satisfaction were assessed using a visual analog scale.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the intention\u2010to\u2010treat analysis, success was higher with KH than with CA (87.5% vs. 71.6%; OR 2.78, 95% CI 1.22\u20136.30;\n p<\/jats:italic>\n \u2009=\u20090.018), with shorter median procedure time (71 vs. 80\u2009min;\n p<\/jats:italic>\n \u2009=\u20090.018). Per\u2010protocol analysis showed similar results (91.9% vs. 77.0%;\n p<\/jats:italic>\n \u2009=\u20090.015). Re\u2010puncture was less frequent with KH but was not statistically significant. Patient and operator satisfaction were significantly higher with KH (both\n p<\/jats:italic>\n \u2009<\u20090.001). Adverse events were comparable, with no major complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n KH improved paracentesis success, shortened procedure time, and increased satisfaction without compromising safety, supporting its use as a practical alternative to CA for repeated paracentesis in refractory ascites.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n ClinicalTrials.gov<\/jats:ext-link>\n : NCT05578573\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgh.70716","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:11:29Z","timestamp":1788498689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Anchoring Catheter Improves the Success, Efficiency, and Satisfaction of Paracentesis in Refractory Ascites: A Multicenter Randomized Crossover Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1653-5806","authenticated-orcid":false,"given":"So Hyun","family":"Jeon","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nae\u2010Yun","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Inje University Haeundae Paik Hospital Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon Ah.","family":"Maeng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-5385","authenticated-orcid":false,"given":"Hae won","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-0381","authenticated-orcid":false,"given":"Jeong\u2010Ju","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-3623","authenticated-orcid":false,"given":"Young Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ha","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Inje University Haeundae Paik Hospital Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Seok","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Korea University Anam Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-777X","authenticated-orcid":false,"given":"Sang Gyune","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1002\/hep.1840070124","article-title":"Compensated Cirrhosis: Natural History and Prognostic Factors","volume":"7","author":"Gines P.","year":"1987","journal-title":"Hepatology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jhep.2005.10.013","article-title":"Natural History and Prognostic Indicators of Survival in Cirrhosis: A Systematic Review of 118 Studies","volume":"44","author":"D'Amico G.","year":"2006","journal-title":"Journal of Hepatology"},{"key":"e_1_2_10_4_1","first-page":"168","article-title":"Natural History and Survival Rate of Chronic Liver Diseases in Korea\u201420 Years Prospective Analysis","volume":"46","author":"Kim C.","year":"1994","journal-title":"Korean Journal of Medicine"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1060073","article-title":"Pathophysiology and Management of Liver Cirrhosis: From Portal Hypertension to Acute\u2010on\u2010Chronic Liver Failure","volume":"10","author":"Jagdish R. K.","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/17474124.2018.1555469","article-title":"An Update on the Pathogenesis and Clinical Management of Cirrhosis With Refractory Ascites","volume":"13","author":"Neong S. F.","year":"2019","journal-title":"Expert Review of Gastroenterology & Hepatology"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.2147\/HMER.S136578","article-title":"Management of Refractory Cirrhotic Ascites: Challenges and Solutions","volume":"10","author":"Fukui H.","year":"2018","journal-title":"Hepatic Medicine: Evidence and Research"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1002\/hep.22853","article-title":"Management of Adult Patients With Ascites due to Cirrhosis: An Update","volume":"49","author":"Runyon B. A.","year":"2009","journal-title":"Hepatology"},{"key":"e_1_2_10_9_1","first-page":"164","article-title":"Definition and Diagnostic Criteria of Refractory Ascites and Hepatorenal Syndrome in Cirrhosis","volume":"23","author":"Arroyo V.","year":"1996","journal-title":"International Ascites Club. Hepatology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3350\/cmh.2022.0104","article-title":"Management of Refractory Ascites","volume":"29","author":"Wong F.","year":"2023","journal-title":"Clinical and Molecular Hepatology"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"961","DOI":"10.3350\/cmh.2026.0281","article-title":"KASL Clinical Practice Guidelines for Liver Cirrhosis: Ascites and Related Complications 2026","volume":"32","author":"Song D. 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A Prospective, Randomized Study","volume":"96","author":"Schlottmann K.","year":"2001","journal-title":"Medizinische Klinik (Munich, Germany)"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.5694\/mja2.51795","article-title":"Diagnostic and Therapeutic Abdominal Paracentesis","volume":"218","author":"Harvey J. 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