Iliac Vein Stenting in Advanced Chronic Venous Insufficiency

NCT ID: NCT02149212

Last Updated: 2014-07-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2014-07-31

Brief Summary

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About 90 % of vascular symptoms affecting the lower limbs consist of venous diseases. Its highest incidence occurs from the second decade of life, affecting significantly the economically active population. Chronic Venous Insufficiency treatment aims to relieve symptoms, treat and prevent complications, prevent recurrences and provide cosmetic satisfaction with minimal side effects. It's current treatment includes some classic postural measures (leg elevation), elastic stockings and bandages compression therapy and possible medication (phlebotonics). The results in the medium and long term are unfavorable, since a large number of patients do not get better or evolves with recurrence of symptoms. Nowadays many, no prospective , not randomized , international studies have shown favorable results with endovascular treatment of obstruction in the iliac vein territory in patients with advanced Chronic Venous Insufficiency . The purpose of this prospective, double-blinded randomized study is to evaluate the results obtained with endovascular treatment, through the use of angioplasty and stenting in this group of patients when compared with clinical treatment .

Detailed Description

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Conditions

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Iliac Vein Obstruction May-Thurner Syndrome Cockett Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Clinical Treatment

Phlebotonics: Aminaftone 75 mg BID Limb elastic compression support (Elastic stockings: Venosan / Elastic Bandages: Atamed) Unna boot dressing

Group Type ACTIVE_COMPARATOR

Phlebotonic

Intervention Type DRUG

Aminaftone -- 75 mg BID

Limb elastic compression support

Intervention Type PROCEDURE

CEAP 3-5 \> 20-30 mmHg compression stockings CEAP 6 \> elastic bandages

Unna boot dressing

Intervention Type PROCEDURE

CEAP 6 \> Unna boot dressing

Iliac vein stenting

Wallstent

Group Type ACTIVE_COMPARATOR

Phlebotonic

Intervention Type DRUG

Aminaftone -- 75 mg BID

Stent

Intervention Type DEVICE

Iliac Vein Stenting

Limb elastic compression support

Intervention Type PROCEDURE

CEAP 3-5 \> 20-30 mmHg compression stockings CEAP 6 \> elastic bandages

Unna boot dressing

Intervention Type PROCEDURE

CEAP 6 \> Unna boot dressing

Interventions

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Phlebotonic

Aminaftone -- 75 mg BID

Intervention Type DRUG

Stent

Iliac Vein Stenting

Intervention Type DEVICE

Limb elastic compression support

CEAP 3-5 \> 20-30 mmHg compression stockings CEAP 6 \> elastic bandages

Intervention Type PROCEDURE

Unna boot dressing

CEAP 6 \> Unna boot dressing

Intervention Type PROCEDURE

Other Intervention Names

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Aminaftone Wallstent Venosan compression stockings Atamed elastic bandages

Eligibility Criteria

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Inclusion Criteria

* Advanced Chronic Venous Insufficiency (CEAP 3-6) submitted to clinical treatment for at least 1 year with no response.
* Subject must be \> 18 and \< 80 years of age
* Willing to participate in and able to understand, read and sign the informed consent document before the planned procedure
* On duplex ultrasound: patent common femoral vein, and patent deep femoral vein, and/or femoral vein of the study leg

Exclusion Criteria

* Subject cannot or will not provide written informed consent
* Previous venous stent implantation involving the study leg or inferior vena cava
* Previous venovenous bypass surgery involving the study leg
* Known metal allergy precluding endovascular stent implantation
* Known reaction or sensitivity to iodinated contrast that cannot be managed with premedication
* Subjects who are pregnant (women of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment
* Acute deep venous thrombosis involving either leg
* Known history of chronic total occlusion of the common femoral vein of the study leg.
* Known history of thrombophilia (e.g., protein C or S deficiency, anti-thrombin III deficiency, presence of lupus anticoagulant, etc.)
* Venous compression caused by tumor encasement
* Venous outflow obstruction caused by tumor thrombus
* Life expectancy of less than 6 months
* Lower Extremity Arterial Insufficiency
* Elevated baseline blood creatinine (value greater than the upper limit of the normal range)
* Any concurrent disease or condition that, in the opinion of the Investigator, would make the subject unsuitable for participation in the study; examples include but are not limited to the inability to lie supine for the index procedure (e.g., severe congestive heart failure), thrombocytopenia or other hematological disorders associated with an unacceptable risk of bleeding, implanted orthopedic hardware that precludes proper imaging, etc.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Fundação de Amparo à Pesquisa do Estado de São Paulo

OTHER_GOV

Sponsor Role collaborator

Instituto Dante Pazzanese de Cardiologia

OTHER

Sponsor Role lead

Responsible Party

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Fabio H Rossi

PHD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fabio H Rossi, PHD

Role: PRINCIPAL_INVESTIGATOR

Instituto Dante Pazzanese de Cardiologia

Locations

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Instituto Dante Pazzanese de Cardilogia

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Alhalbouni S, Hingorani A, Shiferson A, Gopal K, Jung D, Novak D, Marks N, Ascher E. Iliac-femoral venous stenting for lower extremity venous stasis symptoms. Ann Vasc Surg. 2012 Feb;26(2):185-9. doi: 10.1016/j.avsg.2011.05.033. Epub 2011 Oct 22.

Reference Type BACKGROUND
PMID: 22018502 (View on PubMed)

Kolbel T, Lindh M, Akesson M, Wasselius J, Gottsater A, Ivancev K. Chronic iliac vein occlusion: midterm results of endovascular recanalization. J Endovasc Ther. 2009 Aug;16(4):483-91. doi: 10.1583/09-2719.1.

Reference Type BACKGROUND
PMID: 19702343 (View on PubMed)

Raju S. Best management options for chronic iliac vein stenosis and occlusion. J Vasc Surg. 2013 Apr;57(4):1163-9. doi: 10.1016/j.jvs.2012.11.084. Epub 2013 Feb 20.

Reference Type BACKGROUND
PMID: 23433816 (View on PubMed)

Flumignan RL, Nakano LC, Flumignan CD, Baptista-Silva JC. Angioplasty or stenting for deep venous thrombosis. Cochrane Database Syst Rev. 2025 Feb 19;2(2):CD011468. doi: 10.1002/14651858.CD011468.pub2.

Reference Type DERIVED
PMID: 39968829 (View on PubMed)

Lorencao de Almeida B, Rossi FH, Guerra de Moraes Rego Sousa A, Kambara AM, Izukawa NM, Beteli CB, Andrade Cavalcante SF, Rodrigues TO, Thorpe PE. Correlation between venous pressure gradients and intravascular ultrasound in the diagnosis of iliac vein compression syndrome. J Vasc Surg Venous Lymphat Disord. 2018 Jul;6(4):492-499. doi: 10.1016/j.jvsv.2017.11.015. Epub 2018 Mar 8.

Reference Type DERIVED
PMID: 29526687 (View on PubMed)

Rossi FH, Kambara AM, Izukawa NM, Rodrigues TO, Rossi CB, Sousa AG, Metzger PB, Thorpe PE. Randomized double-blinded study comparing medical treatment versus iliac vein stenting in chronic venous disease. J Vasc Surg Venous Lymphat Disord. 2018 Mar;6(2):183-191. doi: 10.1016/j.jvsv.2017.11.003. Epub 2017 Dec 29.

Reference Type DERIVED
PMID: 29292114 (View on PubMed)

Other Identifiers

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IDPC_2 2014

Identifier Type: -

Identifier Source: org_study_id

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