Trial Search Results
Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis
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.
Stanford is currently not accepting patients for this trial.
Washington University School of Medicine
Collaborator: Massachusetts General Hospital
- Drug: Recombinant tissue plasminogen activator (rt-PA)
- 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
- 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
- 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 <
- 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
- 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,
- 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
- Pregnant (positive pregnancy test, women of childbearing potential must be tested).
- Recently (< 1 mo) had thrombolysis or is participating in another investigational drug
- 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).
Ages Eligible for Study
16 Years - 75 Years
Genders Eligible for Study