静脈周囲デキサメタゾン療法: 血栓除去後の炎症の軽減を調べて、急性大腿膝窩 DVT に利益をもたらす (DEXTERITY-AFP)
静脈周囲デキサメタゾン療法: 血栓除去後の炎症の軽減を調べて、急性大腿膝窩部 DVT (DEXTERITY-AFP) に利益をもたらす
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.
調査の概要
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究連絡先
- 名前:Kirk Seward, PhD
- 電話番号:510-614-4550
- メール:kseward@mercatormed.com
研究場所
-
-
-
Galway、アイルランド、H91 YR71
- 完了
- Galway University Hospital
-
-
-
-
Arizona
-
Scottsdale、Arizona、アメリカ、85260
- 募集
- HonorHealth
-
-
California
-
Orange、California、アメリカ、92868
- 募集
- Providence St. Joseph Hospital
-
-
Connecticut
-
Darien、Connecticut、アメリカ、06820
- 募集
- Vascular Care Connecticut
-
-
Florida
-
Atlantis、Florida、アメリカ、33462
- 募集
- HCA Florida JFK Hospital
-
Jacksonville、Florida、アメリカ、32258
- 完了
- Baptist Health
-
Tampa、Florida、アメリカ、33060
- 募集
- University of South Florida
-
-
Georgia
-
Atlanta、Georgia、アメリカ、30303
- 募集
- Grady Memorial Hospital
-
Atlanta、Georgia、アメリカ、30309
- 募集
- Piedmont Heart Institute
-
-
Louisiana
-
Houma、Louisiana、アメリカ、70360
- 募集
- CIS Clinical Research
-
-
Maryland
-
Hyattsville、Maryland、アメリカ、20782
- 募集
- Medstar Health Research Institute
-
-
New Jersey
-
Englewood、New Jersey、アメリカ、07631
- 募集
- Englewood Health
-
-
New York
-
Stony Brook、New York、アメリカ、11794
- 募集
- Stony Brook University Hospital
-
-
North Carolina
-
Raleigh、North Carolina、アメリカ、27607
- 募集
- NC Heart and Vascular Research
-
-
Ohio
-
Columbus、Ohio、アメリカ、43214
- 完了
- OhioHealth Research Institute
-
-
Pennsylvania
-
Pittsburgh、Pennsylvania、アメリカ、15212
- 募集
- Allegheny General Hospital
-
-
Texas
-
Arlington、Texas、アメリカ、76015
- 募集
- HCA Medical City Arlington
-
Houston、Texas、アメリカ、77004
- 募集
- HCA Houston Healthcare Medical Center
-
Plano、Texas、アメリカ、75093
- 募集
- Baylor Scott & White Hospital
-
-
Virginia
-
Norfolk、Virginia、アメリカ、23452
- 募集
- Sentara Norfolk General Hospital
-
-
Washington
-
Seattle、Washington、アメリカ、98133
- 募集
- UW Medical Center - Northwest
-
-
-
-
-
London、イギリス、SE1 7EH
- 積極的、募集していない
- Guy's and St. Thomas Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
偽コンパレータ:コントロール
|
Saline delivery around target vein segment(s) |
|
実験的:処理
|
Dexamethasone delivery around target vein segment(s) |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Rate of clinically relevant primary patency
時間枠: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
時間枠:6 months
|
PTS rate by Villalta score ≥5. |
6 months
|
|
Rate of freedom from major adverse event (MAE)
時間枠: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
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。