Thrombectomy in Pulmonary Embolism (TiPE)
2026年6月22日 更新者：University Hospital Plymouth NHS Trust
Prospective Observational Study to Evaluate the Use of Computer-Aided Vacuum Thrombectomy Within the Context of Intermediate and High-Risk Pulmonary Embolism
Pulmonary embolism is a blood clot on the lung, which can cause death or significant reduced quality of life.
Sucking the clot out with a special tube (catheter) is a relatively new procedure that can be performed but doesn't have the data required to properly support its use in some patients.
We know this procedure works in patients who have no other options and would almost certainly die without intervention.
We currently don't know how well this procedure is tolerated, how well it works and what its complications are in patients who are moderately to severely unwell.
The National Institute of Clinical Excellence (NICE), an advisory body, suggests more data is required to support its use in patients who are sick or very sick.
This registry aims to support this growing evidence base to workout if the treatment is effective and the associated risks that come with using it.
We are collecting data about this procedure and other treatments patients get offered to better inform clinicians and researchers.
調査の概要
状態
募集
条件
詳細な説明
Acute intermediate-risk pulmonary embolism (PE) and high-risk PE can be life threatening.
The incidence of PE is increasing , and patients who survive the acute presentation may experience significant morbidity including reduced exercise tolerance, and decreased quality of life (QoL).
Often patients are treated with anticoagulation to stop the clot getting worse and encourage the body to slowly break up the clot.
However in more severe cases thrombolysis medication can be given to actively break up the clot.
Catheter directed thrombolysis can be used to target the lytic medication into the pulmonary arteries and reduced the systemic effects.
Percutaneous thrombectomy is a newer treatment option that aspirates the clot, providing a faster and potentially lytic free solution to sick patients.
Pulmonary artery thrombectomy (PAT) is a treatment option that is variably utilised and has unclear evidence base .
The penumbra device uses a computer modulated vacuum aspiration system to both fatigue, breakup and aspirate the clot.
This has been shown to be safe and effective in small cohorts.
CAVT can prevent acute hemodynamic decompensation, alleviate acute PE-related symptoms, accelerate right ventricular recovery, and improve quality of life as measured by patient-reported outcomes (PROs).
Despite existing literature addressing clinical outcomes with PE treatment, comprehensive data on PE-related morbidity, PROs and longer-term outcomes after mechanical thrombectomy are still lacking.
研究の種類
観察的
入学 (推定)
2000
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究連絡先
- 名前：Paul Jenkins
- 電話番号：01752438000
- メール：plh-tr.tipe@nhs.net
研究連絡先のバックアップ
- 名前：Thomas Mindos Trial Manager
- 電話番号：01752438000
- メール：plh-tr.tipe@nhs.net
研究場所
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Plymouth、イギリス
- 募集
- University Hospital Plymouth NHS Trust
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コンタクト：
- Paul Jenkins BMBS, Bsc
- 電話番号：01752438000
- メール：plh-tr.tipe@nhs.net
-
-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
いいえ
サンプリング方法
非確率サンプル
調査対象母集団
Patients with PE <14 days and evidence of right heart strain
説明
Inclusion Criteria:
- Clinical signs and symptoms consistent with acute pulmonary embolism with duration of 14 days or less
- Patients who present with computed tomography confirmed pulmonary embolism
- Defined as intermediate or high-risk pulmonary embolism (according to European Society of Cardiology guidelines)
- Date of computed tomography imaging from within a two-year period
- Patient is greater than or equal to 18 years of age
- Informed consent obtained
- Evidence of cardiac dysfunction (either biochemical or imaging features of right heart strain)
Exclusion Criteria:
- Known serious, uncontrolled sensitivity to radiographic agents
- Computed tomography not available to evaluate pulmonary embolism
- Low-risk pulmonary embolism as defined by European Society of Cardiology guidelines
- Current participation in another investigational drug or device study that may confound the results of this study. Studies requiring extended follow-up for products that were investigational but have since become commercially available are not considered investigational
- Other medical, social, or psychological conditions that, in the opinion of the investigator, preclude the patient from appropriate consent, could limit the patient's ability to participate in the study, including compliance with follow-up requirements, or that could impact the scientific integrity of the study
Inclusion Criteria:
- Clinical signs and symptoms consistent with acute PE with duration of 14 days or less
- Patients who present with CT confirmed PE
- Defined as intermediate or high-risk PE (according to ESC guidelines1)
- Date of CT imaging from within a two-year period
- Patient is ≥ 18 years of age
- Informed consent obtained
- Evidence of cardiac dysfunction (Either biochemical or imaging features of RHS)
Exclusion Criteria:
- 1. Known serious, uncontrolled sensitivity to radiographic agents 2. CT not available to evaluate PE 3. Low Risk PE as defined by ESC guidelines1 4. Current participation in another investigational drug or device study that may confound the results of this study. Studies requiring extended follow-up for products that were investigational but have since become commercially available are not considered investigational studies 5. Other medical, social, or psychological conditions that, in the opinion of the Investigator, precludes the patient from appropriate consent, could limit the patient's ability to participate in the study, including compliance with follow-up requirements, or that could impact the scientific integrity of the study
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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CAVT thrombectomy
PE with evidence of right heart strain and thrombectomy with 16Fr CAVT
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PE with evidence of right heart strain
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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 |
|---|---|---|
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LV/RV ratio
時間枠：48 (+ 48 /- 24) hours post procedure.
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1. To evaluate the effectiveness of PE CAVT as a treatment for intermediate and high-risk PE as measured by change pulmonary arterial pressure and in RV/LV (Right Ventricle to Left Ventricle diameter) ratio at 48 (+ 48 /- 24) hours post procedure.
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48 (+ 48 /- 24) hours post procedure.
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Morbidity and mortality
時間枠：within 48 (± 12) hours post procedure, 30 (± 7) days, 90 (± 14) days and at 6months (+/- 30 days).
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Ascertain the mortality and morbidity profile for CAVT within intermediate and high-risk PE, within 48 (± 12) hours post procedure, 30 (± 7) days, 90 (± 14) days and at 6months (+/- 30 days).
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within 48 (± 12) hours post procedure, 30 (± 7) days, 90 (± 14) days and at 6months (+/- 30 days).
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jimenez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ni Ainle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Belle E, Zamorano JL; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543-603. doi: 10.1093/eurheartj/ehz405. No abstract available.
- Konstantinides SV, Barco S, Lankeit M, Meyer G. Management of Pulmonary Embolism: An Update. J Am Coll Cardiol. 2016 Mar 1;67(8):976-990. doi: 10.1016/j.jacc.2015.11.061.
- Sista AK, Miller LE, Kahn SR, Kline JA. Persistent right ventricular dysfunction, functional capacity limitation, exercise intolerance, and quality of life impairment following pulmonary embolism: Systematic review with meta-analysis. Vasc Med. 2017 Feb;22(1):37-43. doi: 10.1177/1358863X16670250. Epub 2016 Oct 5.
- 11. National institute of Clinical Excellence. Pulmonary embolism: what are the risk factors. NICE guidelines. https://cks.nice.org.uk/topics/pulmonary-embolism/background-information/risk-factors/
- Noble S, Lewis R, Whithers J, Lewis S, Bennett P. Long-term psychological consequences of symptomatic pulmonary embolism: a qualitative study. BMJ Open. 2014 Apr 2;4(4):e004561. doi: 10.1136/bmjopen-2013-004561.
- Danielsbacka JS, Rostberg L, Olsen MF, Mannerkorpi K. "Whole life changed" - Experiences of how symptoms derived from acute pulmonary embolism affects life. A qualitative interview study. Thromb Res. 2021 Sep;205:56-62. doi: 10.1016/j.thromres.2021.07.004. Epub 2021 Jul 5.
- 8. Perkowski, Paul et al Computer-aided Mechanical Aspiration Thrombectomy with the Indigo Lightning 12 Aspiration System for the Treatment of Acute Pulmonary Embolism: Interim Analysis of the STRIKE-PE Study.Journal of Vascular Surgery, Volume 77, Issue 4, 52S - 53S
- Moriarty JM, Dohad SY, Schiro BJ, Tamaddon H, Heithaus RE, Iliadis EA, Dexter DJ 2nd, Shavelle DM, Leal SRN, Attallah AS, West FM, Keeling WB, Sharp ASP, Weinberg I. Clinical, Functional, and Quality-of-Life Outcomes after Computer Assisted Vacuum Thrombectomy for Pulmonary Embolism: Interim Analysis of the STRIKE-PE Study. J Vasc Interv Radiol. 2024 Aug;35(8):1154-1165.e6. doi: 10.1016/j.jvir.2024.04.028. Epub 2024 May 9.
- Mathews SJ. Mechanical Thrombectomy of Pulmonary Emboli With Use of the Indigo System and Lightning 12 Intelligent Aspiration. Tex Heart Inst J. 2021 Nov 1;48(5):e217571. doi: 10.14503/THIJ-21-7571. No abstract available.
- Gotzinger F, Lauder L, Sharp ASP, Lang IM, Rosenkranz S, Konstantinides S, Edelman ER, Bohm M, Jaber W, Mahfoud F. Interventional therapies for pulmonary embolism. Nat Rev Cardiol. 2023 Oct;20(10):670-684. doi: 10.1038/s41569-023-00876-0. Epub 2023 May 12.
- Giri J, Sista AK, Weinberg I, Kearon C, Kumbhani DJ, Desai ND, Piazza G, Gladwin MT, Chatterjee S, Kobayashi T, Kabrhel C, Barnes GD. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association. Circulation. 2019 Nov 12;140(20):e774-e801. doi: 10.1161/CIR.0000000000000707. Epub 2019 Oct 4.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2026年5月11日
一次修了 (推定)
2029年12月11日
研究の完了 (推定)
2029年12月11日
試験登録日
最初に提出
2026年6月10日
QC基準を満たした最初の提出物
2026年6月10日
最初の投稿 (実際)
2026年6月16日
学習記録の更新
投稿された最後の更新 (実際)
2026年6月25日
QC基準を満たした最後の更新が送信されました
2026年6月22日
最終確認日
2026年6月1日
詳しくは
本研究に関する用語
その他の研究ID番号
- 24RAD100
- 362530 (その他の識別子：IRAS)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
未定
IPD プランの説明
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Consideration will be given to:
- The viability and suitability of the request
- Appropriate steps have been taken to minimise the risk of identifying participants
- Data security policies and procedures of recipient organisation (including country if abroad) and other regulatory requirements are applicable
- The credentials of the requestor Where access to requested data is granted, requesters organisation must sign a data sharing agreement before they can access any data.
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