- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT04862468
Tratamiento con dexametasona perivenosa: examen de la reducción de la inflamación después de la extracción del trombo para obtener beneficios en la TVP femoropoplítea aguda (DEXTERITY-AFP)
Terapia perivenosa con dexametasona: examen de la reducción de la inflamación después de la extracción del trombo para obtener beneficios en la TVP femoropoplítea aguda (DEXTERITY-AFP)
This is a study of a medical procedure that utilizes a commercially available catheter (the Bullfrog® Micro-Infusion Device) to locally deliver a commercially available anti-inflammatory drug (dexamethasone sodium phosphate injection) around the deep veins after DVT recanalization, where DVT symptoms were present for up to 14 days prior to recanalization. The goal of the study is to see if local anti-inflammation helps prevent re-thrombosis of the blood vessel and improvement in symptoms for up to 24 months after the initial DVT recanalization procedure.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Estimado)
Fase
- Fase 2
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Kirk Seward, PhD
- Número de teléfono: 510-614-4550
- Correo electrónico: kseward@mercatormed.com
Ubicaciones de estudio
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Arizona
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Scottsdale, Arizona, Estados Unidos, 85260
- Reclutamiento
- HonorHealth
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California
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Orange, California, Estados Unidos, 92868
- Reclutamiento
- Providence St. Joseph Hospital
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Connecticut
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Darien, Connecticut, Estados Unidos, 06820
- Reclutamiento
- Vascular Care Connecticut
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Florida
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Atlantis, Florida, Estados Unidos, 33462
- Reclutamiento
- HCA Florida JFK Hospital
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Jacksonville, Florida, Estados Unidos, 32258
- Terminado
- Baptist Health
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Tampa, Florida, Estados Unidos, 33060
- Reclutamiento
- University of South Florida
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Georgia
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Atlanta, Georgia, Estados Unidos, 30303
- Reclutamiento
- Grady Memorial Hospital
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Atlanta, Georgia, Estados Unidos, 30309
- Reclutamiento
- Piedmont Heart Institute
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Louisiana
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Houma, Louisiana, Estados Unidos, 70360
- Reclutamiento
- CIS Clinical Research
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Maryland
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Hyattsville, Maryland, Estados Unidos, 20782
- Reclutamiento
- Medstar Health Research Institute
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New Jersey
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Englewood, New Jersey, Estados Unidos, 07631
- Reclutamiento
- Englewood Health
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New York
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Stony Brook, New York, Estados Unidos, 11794
- Reclutamiento
- Stony Brook University Hospital
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North Carolina
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Raleigh, North Carolina, Estados Unidos, 27607
- Reclutamiento
- NC Heart and Vascular Research
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Ohio
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Columbus, Ohio, Estados Unidos, 43214
- Terminado
- OhioHealth Research Institute
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Pennsylvania
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Pittsburgh, Pennsylvania, Estados Unidos, 15212
- Reclutamiento
- Allegheny General Hospital
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Texas
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Arlington, Texas, Estados Unidos, 76015
- Reclutamiento
- HCA Medical City Arlington
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Houston, Texas, Estados Unidos, 77004
- Reclutamiento
- HCA Houston Healthcare Medical Center
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Plano, Texas, Estados Unidos, 75093
- Reclutamiento
- Baylor Scott & White Hospital
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Virginia
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Norfolk, Virginia, Estados Unidos, 23452
- Reclutamiento
- Sentara Norfolk General Hospital
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Washington
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Seattle, Washington, Estados Unidos, 98133
- Reclutamiento
- UW Medical Center - Northwest
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Galway, Irlanda, H91 YR71
- Terminado
- Galway University Hospital
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London, Reino Unido, SE1 7EH
- Activo, no reclutando
- Guy's and St. Thomas Hospital
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Provision of signed and dated informed consent form prior to receiving any non-standard of care, protocol-specific procedures.
- Stated willingness to comply with all study procedures including completion of questionnaires and follow-up visits and availability for the duration of the study.
- Male or female, aged 18 to 89 years.
- For females of reproductive potential: use of highly effective contraception (abstinence is acceptable) for at least 1 month prior to study treatment (unless they had given birth within the 1 month prior to study treatment), and agreement to use such a method for at least 30 days after study treatment.
- Onset of acute DVT symptoms of 14 days or less prior to initial intervention in the study limb.
- Ability to take oral medication and be willing to adhere to the prescribed anti-coagulant regimen.
- Post-procedural prescription for at least 28 days low molecular weight heparin followed by therapeutic anticoagulant of investigator's choice for 12 months minimum as part of post-interventional medication regimen.
- Minimum of 28 days of prescribed antiplatelet agent (aspirin or P2Y12 inhibitor) for patients receiving stents.
- DVT located in any of the major femoropopliteal veins (common femoral, femoral, and/or popliteal above the tibial plateau), with possible extension downstream into the iliac veins.
- Successful recanalization of the target vein with removal of acute thrombus.
Exclusion Criteria:
- Current enrollment in another non-registry clinical study of systemic drug therapy or another device study that has not completed its primary endpoint, including prior enrollment in this study. Concurrent enrollment in registry studies of approved devices or drugs are acceptable.
- Lack of capability of understanding the nature, significance and implications of the clinical trial.
- Body Mass Index between 40 kg/m2 and 45 kg/m2, with significant comorbidity which, in the Investigator's discretion, could impair follow-up or study outcomes.
- Body Mass Index > 45 kg/m2.
- Non-ambulatory status prior to DVT occurrence.
- In the study leg: current established PTS (Villalta ≥ 5 for more than 14 days), current known symptomatic deep venous insufficiency for more than 14 days, or previous symptomatic DVT within the last 365 days.
- In the contralateral (non-study) leg: symptomatic DVT that, in the opinion of the operating physician, will require a subsequent open or endovascular surgery in the following 30 days.
- In cases with symptoms of limb-threatening circulatory compromise, ankle-brachial index <0.4, absolute ankle pressure <50 mmHg or absolute toe pressure <30 mmHg.
- Pulmonary embolism (PE) defined as either massive (systolic blood pressure < 90 mmHg and/or patient on IV vasoactive medication to support blood pressure), or intermediate high-risk PE, as defined by the European Society Guideline on management of PE. Low-risk PE and/or intermediate low-risk PE can be enrolled.
- Inability to tolerate contemporary venous intervention procedure due to severe dyspnea or acute systemic illness.
- Allergy or hypersensitivity to any drugs planned for use in the case (including dexamethasone sodium phosphate, iodinated contrast, low molecular-weight heparin, or recombinant tissue plasminogen activator, rtPA, if planned), except for mild-moderate contrast allergies for which steroid pre-medication can be used.
- History of, or active heparin-induced thrombocytopenia (HIT).
- Hemoglobin < 8.0 g/dl.
- INR > 1.6 before starting anticoagulation.
- Platelets < 100,000/ml.
- Severe renal impairment (estimated glomerular filtration rate < 30 ml/min).
- Active bleeding, recent (< 1 mo) GI bleeding, severe liver dysfunction, bleeding diathesis.
- Recent (< 3 mo) internal eye surgery or hemorrhagic retinopathy.
- Recent (< 10 days) major surgery, trauma, cardiopulmonary resuscitation, or other invasive procedure which, in the Investigator's discretion, could impair follow-up or study outcomes.
- Obstetrical delivery <72 hours prior to procedure.
- Hemorrhagic stroke within the last 365 days.
- Intracranial/intraspinal bleed within the last 365 days.
- Intracranial/intraspinal tumor within the last 365 days.
- Intracranial/intraspinal vascular malformation within the last 365 days.
- Intracranial/intraspinal aneurysm within the last 365 days.
- Active symptomatic COVID-19 infection that, in the Investigator's discretion, could impair follow-up or study outcomes.
- Severe hypertension on repeated readings (systolic blood pressure > 180 mmHg or diastolic blood pressure > 105 mmHg). This can be treated, and blood pressure must be stable before venous access is obtained (systolic blood pressure <140 mmHg).
- Pregnant or breastfeeding.
- Life expectancy < 2 years (e.g. due to active cancer).
- Major thrombus of the inferior vena cava (IVC) (occlusive or near-occlusive) extending at least one centimeter above the common iliac confluence.
- Inability to obtain venous access.
- Inability to recanalize the target vein segment with less than 30% residual obstruction due to thrombus.
- History of ipsilateral venous stent.
- DVT target length intended for drug treatment exceeds 50 cm.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Cuadruplicar
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Comparador falso: Control
|
Saline delivery around target vein segment(s) |
|
Experimental: Tratamiento
|
Dexamethasone delivery around target vein segment(s) |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Rate of clinically relevant primary patency
Periodo de tiempo: 6 months
|
Rate of freedom from loss of patency (defined as 100% occlusion of unstented vein or 50% stenosis of stented vein measured by duplex ultrasound or angiogram) with associated symptoms |
6 months
|
|
Limit the progression to PTS
Periodo de tiempo: 6 months
|
PTS rate by Villalta score ≥5. |
6 months
|
|
Rate of freedom from major adverse event (MAE)
Periodo de tiempo: 30 days
|
Rate of freedom from composite of all-cause death, clinically significant pulmonary embolism, major bleeding, target vessel thrombosis, infection of treatment or insertion site, or AV fistula of treatment site |
30 days
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- CIP0217
- R44HL160434 (Subvención/contrato del NIH de EE. UU.)
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
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