Rivaroxaban for the Prevention of Deep Vein Thrombosis in Patients With Left Iliac Vein Compression - The PLICTS Study

NCT ID: NCT04067505

Last Updated: 2024-04-18

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

224 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-18

Study Completion Date

2024-12-31

Brief Summary

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The purpose of this study is to evaluate the efficacy and safety of rivaroxaban for the prevention of deep vein thrombosis in patients with left iliac vein compression treated with stent implantation.

Detailed Description

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Left Iliac Vein Compression Syndrome (LIVCS) is a disease of iliac vein stenosis/occlusion caused by chronic friction and compression of the left iliac vein by the right common iliac artery and lumbar vertebra. It is also called Cockett syndrome or May-Thurner syndrome. Recently, left iliac vein balloon dilatation with stent implantation have been used to treat patients with LIVCS, and have achieved good results. However, no matter the iliac vein stenosis or occlusion, interventional therapy can directly cause local trauma and intimal injury, which is a clear inducement of local thrombosis. Therefore, high intensity anticoagulation therapy is still needed to prevent secondary thrombosis in stent after left iliac vein balloon dilatation with stent implantation. At present, the postoperative anticoagulation regimen of these patients is early heparin anticoagulant therapy, and later warfarin anticoagulant therapy. However, due to the narrow therapeutic window of the drug, patients need to adjust the dosage according to coagulation function under the guidance of doctors. Rivaroxaban can simplify treatment, and is safe. Previous studies have shown that rivaroxaban is effective in preventing deep venous thrombosis after orthopaedic surgery. Rivaroxaban has also been shown to be safe and effective in anticoagulation therapy for patients with deep venous thrombosis and pulmonary embolism. However, Rivaroxaban lacks sufficient clinical data for adjuvant anticoagulation therapy after balloon dilatation with stent implantation. Therefore, this study should be carried out to provide the basis for LIVCS treatment guidelines and explore the clinical indications of rivaroxaban.

Conditions

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May-Thurner Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Rivaroxaban

Participants will receive rivaroxaban 15mg twice daily for three weeks, then 20mg oral once daily after operation.

Group Type EXPERIMENTAL

Rivaroxaban

Intervention Type DRUG

Dose: 15mg twice daily for three weeks, then 20mg once daily until six months after the operation. Application: oral

Warfarin/Nadroparin

Participants will receive nadroparin 1mg/kg twice daily (subcutaneous), plus warfarin 3mg oral once daily for 5 days after the operation, later warfarin(oral) at individually titrated doses(0.75mg to 18mg) to achieve a target international normalized ratio (INR) of 2.0 to 3.0, once daily until 6 months.

Group Type ACTIVE_COMPARATOR

Warfarin

Intervention Type DRUG

Dose: 3mg for 5 days after the operation, later 0.75mg to 18mg depending on INR (2.0-3.0) until 6 months Duration: 6 months Frequency: once daily Application: oral

Nadroparin

Intervention Type DRUG

Dose: 1mg/kg Duration: 5 days after the operation Frequency: twice daily Application: subcutaneous

Interventions

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Rivaroxaban

Dose: 15mg twice daily for three weeks, then 20mg once daily until six months after the operation. Application: oral

Intervention Type DRUG

Warfarin

Dose: 3mg for 5 days after the operation, later 0.75mg to 18mg depending on INR (2.0-3.0) until 6 months Duration: 6 months Frequency: once daily Application: oral

Intervention Type DRUG

Nadroparin

Dose: 1mg/kg Duration: 5 days after the operation Frequency: twice daily Application: subcutaneous

Intervention Type DRUG

Other Intervention Names

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Xarelto coumadin Fraxiparin

Eligibility Criteria

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Inclusion Criteria

* Patients with thrombotic left iliac vein compression syndrome who underwent left iliac vein stent implantation

Exclusion Criteria

* Age \< 18 years or age \> 75 years
* With history of pelvic surgery, left iliac vein trauma and pelvic radiotherapy
* With obvious contraindications for anticoagulation therapy
* Allergic to iodine contrast agents in the past
* With concomitant diseases that need high-intensity anticoagulation, and the anticoagulation intensity is clearly higher than that of the patients with iliac vein therapy alone
* Active bleeding or potential bleeding risk
* Pregnant or breastfeeding women
* With pelvic tumors causing compression of left iliac vein,
* With chronic venous insufficiency of lower extremities caused by K-T syndrome
* With malignant tumors and life expectancy \< 1 year
* Taking cytochrome P450 3A4(CYP-450 3A4) inhibitors or inducers
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sir Run Run Shaw Hospital

OTHER

Sponsor Role collaborator

Huadong Hospital

OTHER

Sponsor Role collaborator

Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Shanghai 5th People's Hospital

OTHER

Sponsor Role collaborator

Yantai Yuhuangding Hospital

OTHER

Sponsor Role collaborator

Anhui Provincial Hospital

OTHER_GOV

Sponsor Role collaborator

Zhejiang Provincial People's Hospital

OTHER

Sponsor Role collaborator

Zhejiang Hospital

OTHER

Sponsor Role collaborator

Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role lead

Responsible Party

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Zhenjie Liu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zhejie Liu, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Second Affiliated Hospital, School of Medicine, Zhejiang University

Locations

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Anhui Provincial Hospital

Hefei, Anhui, China

Site Status RECRUITING

Yantai Yuhuangding Hospital

Yantai, Shangdong, China

Site Status RECRUITING

Huadong Hospital affiliated to Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai 5th People's Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Zhongshan Hospital affiliated to Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Sir Run Run Shaw Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

The second affiliated hospital of zhejiang university school of medicine

Hangzhou, Zhejiang, China

Site Status RECRUITING

Zhejiang Provincial people's hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

Zhejiang Xiaoshan Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Li Yin

Role: CONTACT

86-0571-87913706

Facility Contacts

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Zhengdong Fang

Role: primary

15256990126 ext. 86

Lubin Li, MD

Role: primary

18653587255 ext. 86

Wan Zhang, MD,PhD

Role: primary

13916056910 ext. 86

Bin Gao, MD,PhD

Role: primary

13764979078 ext. 86

Jianing Yue, MD,PhD

Role: primary

13564788422 ext. 86

Yuefeng Zhu, MD

Role: primary

13868101010 ext. 86

Zhejie Liu, MD,PhD

Role: primary

15268135830 ext. 86

Guangwei Yang

Role: primary

13758146564

Wei Han

Role: primary

18957113906

References

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Liu Z, Gao N, Shen L, Yang J, Zhu Y, Li Z, Si Y. Endovascular treatment for symptomatic iliac vein compression syndrome: a prospective consecutive series of 48 patients. Ann Vasc Surg. 2014 Apr;28(3):695-704. doi: 10.1016/j.avsg.2013.05.019. Epub 2013 Oct 27.

Reference Type BACKGROUND
PMID: 24559785 (View on PubMed)

O'Sullivan GJ, Semba CP, Bittner CA, Kee ST, Razavi MK, Sze DY, Dake MD. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2000 Jul-Aug;11(7):823-36. doi: 10.1016/s1051-0443(07)61796-5.

Reference Type BACKGROUND
PMID: 10928517 (View on PubMed)

Hurst DR, Forauer AR, Bloom JR, Greenfield LJ, Wakefield TW, Williams DM. Diagnosis and endovascular treatment of iliocaval compression syndrome. J Vasc Surg. 2001 Jul;34(1):106-13. doi: 10.1067/mva.2001.114213.

Reference Type BACKGROUND
PMID: 11436082 (View on PubMed)

Eriksson BI, Kakkar AK, Turpie AG, Gent M, Bandel TJ, Homering M, Misselwitz F, Lassen MR. Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement. J Bone Joint Surg Br. 2009 May;91(5):636-44. doi: 10.1302/0301-620X.91B5.21691.

Reference Type BACKGROUND
PMID: 19407299 (View on PubMed)

Turpie AG, Lassen MR, Davidson BL, Bauer KA, Gent M, Kwong LM, Cushner FD, Lotke PA, Berkowitz SD, Bandel TJ, Benson A, Misselwitz F, Fisher WD; RECORD4 Investigators. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial. Lancet. 2009 May 16;373(9676):1673-80. doi: 10.1016/S0140-6736(09)60734-0. Epub 2009 May 4.

Reference Type BACKGROUND
PMID: 19411100 (View on PubMed)

Li M, Zhang L, Zhang K, Zhu Y, Shi Z, Zhang W, Gao B, Li L, Fang Z, Yin L, Chen B, Liu Z. An efficacy and safety study of rivaroxaban for the prevention of deep vein thrombosis in patients with left iliac vein compression treated with stent implantation (PLICTS): study protocol for a prospective randomized controlled trial. Trials. 2020 Sep 29;21(1):811. doi: 10.1186/s13063-020-04742-z.

Reference Type DERIVED
PMID: 32993773 (View on PubMed)

Other Identifiers

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SAHZhejiangU-001

Identifier Type: -

Identifier Source: org_study_id

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