Submassive and Massive Pulmonary Embolism Treatment With Ultrasound Accelerated Thrombolysis Therapy

NCT ID: NCT01513759

Last Updated: 2021-07-19

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-07

Study Completion Date

2013-02-17

Brief Summary

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The purpose of this study is to determine if the EKOS EkoSonic® Endovascular Device when used in conjunction with recombinant tissue plasminogen activator (t-PA) as a treatment for acute PE will decrease the ratio of right ventricle (RV) to left ventricle (LV) diameter within 48 =/- 6 hours in participants with massive or submassive PE.

Detailed Description

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Conditions

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Pulmonary Embolism Acute Pulmonary Embolism Sub-massive Pulmonary Embolism Massive Pulmonary Embolism Pulmonary Thromboembolism

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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EkoSonic® Endovascular System

Participants will receive a total of 24 milligrams (mg) of recombinant t-PA infusion, at an infusion rate of 1 milligrams/hour (mg/hr) per device (2 mg/hour for bilateral PE) delivered through the EkoSonic® Endovascular System. This regimen allows for a recombinant t-PA infusion time of 24 hours for one catheter and 12 hours for two catheters, respectively.

Group Type EXPERIMENTAL

recombinant tissue plasminogen activator

Intervention Type DRUG

Participants will receive 24 mg of r-tPA delivered via the EkoSonic Endovascular Device.

EKOS EkoSonic Endovascular System

Intervention Type DEVICE

24 mg of r-tPA will be delivered through the EkoSonic Endovascular System.

Interventions

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recombinant tissue plasminogen activator

Participants will receive 24 mg of r-tPA delivered via the EkoSonic Endovascular Device.

Intervention Type DRUG

EKOS EkoSonic Endovascular System

24 mg of r-tPA will be delivered through the EkoSonic Endovascular System.

Intervention Type DEVICE

Other Intervention Names

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r-tPA t-PA Alteplase EkoSonic Endovascular Device EkoSonic

Eligibility Criteria

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Inclusion Criteria

* Computed tomography (CT) evidence of proximal PE (filling defect in at least one main or segmental pulmonary artery)
* PE symptom duration less than or equal to (\<=)14 days
* Informed consent can be obtained from participant or Legally Authorized Representative (LAR)
* Massive PE (syncope, systemic arterial hypotension, cardiogenic shock, or resuscitated cardiac arrest) or
* Submassive PE (RV diameter-to-LV diameter greater than or equal to \[\>=\] 0.9 on contrast-enhanced chest CT)

Exclusion Criteria

* Stroke or transient ischemic attack (TIA), head trauma, or other active intracranial or intraspinal disease within one year
* Recent (within one month) or active bleeding from a major organ
* Hematocrit less than (\<) 30 percent (%)
* Platelets \< 100 thousand/microliter (mcL)
* International Normalized Ratio (INR) greater than (\>) 3
* Activated partial thromboplastin time (aPTT) \>50 seconds on no anticoagulants
* Major surgery within seven days of screening for study enrollment
* Serum creatinine \>2 milligrams/deciliter (mg/dL)
* Clinician deems high-risk for catastrophic bleeding
* History of heparin-induced thrombocytopenia (HIT)
* Pregnancy
* Catheter-based pharmacomechanical treatment for pulmonary embolism within 3 days of study enrollment
* Systolic blood pressure less than 80 mm Hg despite vasopressor or inotropic support
* Cardiac arrest (including pulseless electrical activity and asystole) requiring active cardiopulmonary resuscitation (CPR)
* Evidence of irreversible neurological compromise
* Life expectancy \<30 days
* Use of thrombolytics or glycoprotein IIb/IIIa antagonists within 3 days prior to inclusion in the study
* Previous enrollment in the SEATTLE study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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EKOS Corporation

INDUSTRY

Sponsor Role collaborator

Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Narinder Bhalla, MD

Role: PRINCIPAL_INVESTIGATOR

Baptist Health

William Kuo, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford Hospital and Clinics

Stephen K Liu, MD

Role: PRINCIPAL_INVESTIGATOR

Memorial Medical Center - Modesto

Immad Sidiq, MD

Role: PRINCIPAL_INVESTIGATOR

Hartford Hospital

Samuel Z Goldhaber, MD

Role: STUDY_CHAIR

Brigham and Women's

Mark J Garcia, MD

Role: PRINCIPAL_INVESTIGATOR

Christiana Hospital

Rohit Bhatheja, MD

Role: PRINCIPAL_INVESTIGATOR

AdventHealth

Robert Kennedy, MD

Role: PRINCIPAL_INVESTIGATOR

Holmes Regional Medical Center

Fakhir Elmasri, MD

Role: PRINCIPAL_INVESTIGATOR

Lakeland Regional Medical Center

Barry S Weinstock, MD

Role: PRINCIPAL_INVESTIGATOR

Orlando Regional Medical Center

Juan Ayerdi, MD

Role: PRINCIPAL_INVESTIGATOR

Medical Center of Central Georgia

Nilesh Goswami, MD

Role: PRINCIPAL_INVESTIGATOR

Prairie Heart Institute - St.John's Hospital

Kannan Natarajan, MD

Role: PRINCIPAL_INVESTIGATOR

St Vincent's Hospital

Tod C Engelhardt, MD

Role: PRINCIPAL_INVESTIGATOR

East Jefferson General Hospital

Mark Kumar, MD

Role: PRINCIPAL_INVESTIGATOR

Overlook Medical Center

John Rundback, MD

Role: PRINCIPAL_INVESTIGATOR

Holy Name Hospital

Jacob Cynamon, MD

Role: PRINCIPAL_INVESTIGATOR

Montefiore Medical Center

Peter Soukas, MD

Role: PRINCIPAL_INVESTIGATOR

The Miriam Hospital

Mohammad L Raja, MD

Role: PRINCIPAL_INVESTIGATOR

Providence Memorial Hospital - Sierra Vista Hospital

Keith M Sterling, MD

Role: PRINCIPAL_INVESTIGATOR

Inova Alexandria

John Gurley, MD

Role: PRINCIPAL_INVESTIGATOR

University of Kentucky

Noah Jones, MD

Role: PRINCIPAL_INVESTIGATOR

Mt. Carmel East

Locations

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Baptist Health

Montgomery, Alabama, United States

Site Status

Memorial Medical Center

Modesto, California, United States

Site Status

Stanford University Medical Center

Stanford, California, United States

Site Status

Hartford Hospital

Hartford, Connecticut, United States

Site Status

Christiana Hospital

Newark, Delaware, United States

Site Status

Lakeland Regional Medical Center

Lakeland, Florida, United States

Site Status

Holmes Regional Medical Center

Melbourne, Florida, United States

Site Status

Florida Hospital

Orlando, Florida, United States

Site Status

Orlando Regional Medical Center

Orlando, Florida, United States

Site Status

Medical Center of Central Georgia

Macon, Georgia, United States

Site Status

Prairie Heart Institute

Springfield, Illinois, United States

Site Status

St. Vincent Hospital

Indianapolis, Indiana, United States

Site Status

University of Kentucky, Gill Heart Institute

Lexington, Kentucky, United States

Site Status

East Jefferson General Hospital

New Orleans, Louisiana, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Overlook Medical Center

Morristown, New Jersey, United States

Site Status

Holy Name Hospital

Teaneck, New Jersey, United States

Site Status

Montefiore Medical Center

The Bronx, New York, United States

Site Status

Mt. Carmel East

Columbus, Ohio, United States

Site Status

The Miriam Hospital

Providence, Rhode Island, United States

Site Status

Providence Memorial and Sierra Medical Center

El Paso, Texas, United States

Site Status

Inova Alexandria Hospital

Alexandria, Virginia, United States

Site Status

Countries

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United States

References

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Sadiq I, Goldhaber SZ, Liu PY, Piazza G; Submassive and Massive Pulmonary Embolism Treatment with Ultrasound AcceleraTed ThromboLysis ThErapy (SEATTLE II) Investigators. Risk factors for major bleeding in the SEATTLE II trial. Vasc Med. 2017 Feb;22(1):44-50. doi: 10.1177/1358863X16676355. Epub 2017 Jan 31.

Reference Type DERIVED
PMID: 27913777 (View on PubMed)

Piazza G, Hohlfelder B, Jaff MR, Ouriel K, Engelhardt TC, Sterling KM, Jones NJ, Gurley JC, Bhatheja R, Kennedy RJ, Goswami N, Natarajan K, Rundback J, Sadiq IR, Liu SK, Bhalla N, Raja ML, Weinstock BS, Cynamon J, Elmasri FF, Garcia MJ, Kumar M, Ayerdi J, Soukas P, Kuo W, Liu PY, Goldhaber SZ; SEATTLE II Investigators. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. JACC Cardiovasc Interv. 2015 Aug 24;8(10):1382-1392. doi: 10.1016/j.jcin.2015.04.020.

Reference Type DERIVED
PMID: 26315743 (View on PubMed)

Other Identifiers

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EKOS 09

Identifier Type: -

Identifier Source: org_study_id

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