Perivenous Dexamethasone Therapy: Examining Reduction of Inflammation After Thrombus Removal to Yield Benefit in Acute Femoropopliteal DVT

NCT ID: NCT04862468

Last Updated: 2025-07-04

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

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-29

Study Completion Date

2028-02-01

Brief Summary

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This is a study of a medical procedure that utilizes a commercially available catheter (the Bullfrog® Micro-Infusion Device) to locally deliver a commercially available anti-inflammatory drug (dexamethasone sodium phosphate injection) around the deep veins after DVT recanalization, where DVT symptoms were present for up to 14 days prior to recanalization. The goal of the study is to see if local anti-inflammation helps prevent re-thrombosis of the blood vessel and improvement in symptoms for up to 24 months after the initial DVT recanalization procedure.

Detailed Description

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Conditions

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Thrombosis, Deep Vein Iliofemoral; Thrombosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Treatment

Group Type EXPERIMENTAL

Perivascular dexamethasone

Intervention Type COMBINATION_PRODUCT

Dexamethasone delivery around target vein segment(s)

Control

Group Type SHAM_COMPARATOR

Perivascular sham

Intervention Type COMBINATION_PRODUCT

Saline delivery around target vein segment(s)

Interventions

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Perivascular dexamethasone

Dexamethasone delivery around target vein segment(s)

Intervention Type COMBINATION_PRODUCT

Perivascular sham

Saline delivery around target vein segment(s)

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

1. Provision of signed and dated informed consent form prior to receiving any non-standard of care, protocol-specific procedures.
2. Stated willingness to comply with all study procedures including completion of questionnaires and follow-up visits and availability for the duration of the study.
3. Male or female, aged 18 to 89 years.
4. For females of reproductive potential: use of highly effective contraception (abstinence is acceptable) for at least 1 month prior to study treatment (unless they had given birth within the 1 month prior to study treatment), and agreement to use such a method for at least 30 days after study treatment.
5. Onset of acute DVT symptoms of 14 days or less prior to initial intervention in the study limb.
6. Ability to take oral medication and be willing to adhere to the prescribed anti-coagulant regimen.
7. Post-procedural prescription for at least 28 days low molecular weight heparin followed by therapeutic anticoagulant of investigator's choice for 12 months minimum as part of post-interventional medication regimen.
8. Minimum of 28 days of prescribed antiplatelet agent (aspirin or P2Y12 inhibitor) for patients receiving stents.
9. DVT located in any of the major femoropopliteal veins (common femoral, femoral, and/or popliteal above the tibial plateau), with possible extension downstream into the iliac veins.
10. Successful recanalization of the target vein with removal of acute thrombus.

Exclusion Criteria

1. Current enrollment in another non-registry clinical study of systemic drug therapy or another device study that has not completed its primary endpoint, including prior enrollment in this study. Concurrent enrollment in registry studies of approved devices or drugs are acceptable.
2. Lack of capability of understanding the nature, significance and implications of the clinical trial.
3. Body Mass Index between 40 kg/m2 and 45 kg/m2, with significant comorbidity which, in the Investigator's discretion, could impair follow-up or study outcomes.
4. Body Mass Index \> 45 kg/m2.
5. Non-ambulatory status prior to DVT occurrence.
6. In the study leg: current established PTS (Villalta ≥ 5 for more than 14 days), current known symptomatic deep venous insufficiency for more than 14 days, or previous symptomatic DVT within the last 365 days.
7. In the contralateral (non-study) leg: symptomatic DVT that, in the opinion of the operating physician, will require a subsequent open or endovascular surgery in the following 30 days.
8. In cases with symptoms of limb-threatening circulatory compromise, ankle-brachial index \<0.4, absolute ankle pressure \<50 mmHg or absolute toe pressure \<30 mmHg.
9. Pulmonary embolism (PE) defined as either massive (systolic blood pressure \< 90 mmHg and/or patient on IV vasoactive medication to support blood pressure), or intermediate high-risk PE, as defined by the European Society Guideline on management of PE. Low-risk PE and/or intermediate low-risk PE can be enrolled.
10. Inability to tolerate contemporary venous intervention procedure due to severe dyspnea or acute systemic illness.
11. Allergy or hypersensitivity to any drugs planned for use in the case (including dexamethasone sodium phosphate, iodinated contrast, low molecular-weight heparin, or recombinant tissue plasminogen activator, rtPA, if planned), except for mild-moderate contrast allergies for which steroid pre-medication can be used.
12. History of, or active heparin-induced thrombocytopenia (HIT).
13. Hemoglobin \< 8.0 g/dl.
14. INR \> 1.6 before starting anticoagulation.
15. Platelets \< 100,000/ml.
16. Severe renal impairment (estimated glomerular filtration rate \< 30 ml/min).
17. Active bleeding, recent (\< 1 mo) GI bleeding, severe liver dysfunction, bleeding diathesis.
18. Recent (\< 3 mo) internal eye surgery or hemorrhagic retinopathy.
19. Recent (\< 10 days) major surgery, trauma, cardiopulmonary resuscitation, or other invasive procedure which, in the Investigator's discretion, could impair follow-up or study outcomes.
20. Obstetrical delivery \<72 hours prior to procedure.
21. Hemorrhagic stroke within the last 365 days.
22. Intracranial/intraspinal bleed within the last 365 days.
23. Intracranial/intraspinal tumor within the last 365 days.
24. Intracranial/intraspinal vascular malformation within the last 365 days.
25. Intracranial/intraspinal aneurysm within the last 365 days.
26. Active symptomatic COVID-19 infection that, in the Investigator's discretion, could impair follow-up or study outcomes.
27. Severe hypertension on repeated readings (systolic blood pressure \> 180 mmHg or diastolic blood pressure \> 105 mmHg). This can be treated, and blood pressure must be stable before venous access is obtained (systolic blood pressure \<140 mmHg).
28. Pregnant or breastfeeding.
29. Life expectancy \< 2 years (e.g. due to active cancer).
30. Major thrombus of the inferior vena cava (IVC) (occlusive or near-occlusive) extending at least one centimeter above the common iliac confluence.
31. Inability to obtain venous access.
32. Inability to recanalize the target vein segment with less than 30% residual obstruction due to thrombus.
33. History of ipsilateral venous stent.
34. DVT target length intended for drug treatment exceeds 50 cm.
Minimum Eligible Age

18 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Mercator MedSystems, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Providence St. Joseph Hospital

Orange, California, United States

Site Status RECRUITING

Vascular Care Connecticut

Darien, Connecticut, United States

Site Status RECRUITING

HCA Florida JFK Hospital

Atlantis, Florida, United States

Site Status RECRUITING

Baptist Health

Jacksonville, Florida, United States

Site Status RECRUITING

University of South Florida

Tampa, Florida, United States

Site Status RECRUITING

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status RECRUITING

CIS Clinical Research

Houma, Louisiana, United States

Site Status RECRUITING

Medstar Health Research Institute

Hyattsville, Maryland, United States

Site Status RECRUITING

Englewood Health

Englewood, New Jersey, United States

Site Status RECRUITING

Stony Brook University Hospital

Stony Brook, New York, United States

Site Status RECRUITING

NC Heart and Vascular Research

Raleigh, North Carolina, United States

Site Status RECRUITING

OhioHealth Research Institute

Columbus, Ohio, United States

Site Status ACTIVE_NOT_RECRUITING

St John Health System

Bartlesville, Oklahoma, United States

Site Status ACTIVE_NOT_RECRUITING

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status RECRUITING

Galway University Hospital

Galway, , Ireland

Site Status COMPLETED

Guy's and St. Thomas Hospital

London, , United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Countries

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United States Ireland United Kingdom

Central Contacts

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Kirk Seward, PhD

Role: CONTACT

510-614-4550

Other Identifiers

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R44HL160434

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CIP0217

Identifier Type: -

Identifier Source: org_study_id

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