Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis
Trial ID or NCT#
Status
Purpose
The purpose of this study is to determine if the use of adjunctive Pharmacomechanical Catheter Directed Thrombolysis, which includes the intrathrombus administration of rt-PA--Activase (Alteplase),can prevent the post-thrombotic syndrome(PTS)in patients with symptomatic proximal deep vein thrombosis(DVT)as compared with optimal standard DVT therapy alone.
Official Title
Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis--The ATTRACT Trial
Eligibility Criteria
- * Symptomatic proximal DVT involving the iliac, common femoral, and/or femoral vein.
- * Age less than 16 years or greater than 75 years.* Symptom duration \> 14 days for the DVT episode in the index leg (i.e., non-acute DVT).* In the index leg: established PTS, or previous symptomatic DVT within the last 2 years.* In the contralateral (non-index) leg: symptomatic acute DVT a) involving the iliac and/or common femoral vein; or b) for which thrombolysis is planned as part of the initial therapy.* Limb-threatening circulatory compromise.* Pulmonary embolism with hemodynamic compromise (i.e., hypotension).* Inability to tolerate PCDT procedure due to severe dyspnea or acute systemic illness.* Allergy, hypersensitivity, or thrombocytopenia from heparin, rt-PA, or iodinated contrast, except for mild-moderate contrast allergies for which steroid pre-medication can be used.* Hemoglobin \< 9.0 mg/dl, INR \> 1.6 before warfarin was started, or platelets \< 100,000/ml.* Moderate renal impairment in diabetic patients (estimated glomerular filtration rate \[GFR\] \< 60 ml/min) or severe renal impairment in non-diabetic patients (estimated GFR \< 30 ml/min).* Active bleeding, recent (\< 3 mo) GI bleeding, severe liver dysfunction, bleeding diathesis.* Recent (\< 3 mo) internal eye surgery or hemorrhagic retinopathy; recent (\< 10 days) major surgery, cataract surgery, trauma, cardiopulmonary resuscitation, obstetrical delivery, or other invasive procedure.* History of stroke or intracranial/intraspinal bleed, tumor, vascular malformation, aneurysm.* Active cancer (metastatic, progressive, or treated within the last 6 months). Exception: patients with non-melanoma primary skin cancers are eligible to participate in the study.* Severe hypertension on repeated readings (systolic \> 180 mmHg or diastolic \> 105 mmHg).* Pregnant (positive pregnancy test, women of childbearing potential must be tested).* Recently (\< 1 mo) had thrombolysis or is participating in another investigational drug study.* Use of a thienopyridine antiplatelet drug (except clopidogrel) in the last 5 days.* Life expectancy \< 2 years or chronic non-ambulatory status.* Inability to provide informed consent or to comply with study assessments (e.g. due to cognitive impairment or geographic distance).
Investigator(s)
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Contact
Kamil Unver
6507259810
View on ClinicalTrials.gov