Venous Vascularization and Inflammation on Contrast-enhanced Ultrasound (CEUS) in Patients With Thrombosis
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Purpose
Background:
Contrast-enhanced ultrasound (CEUS) visualization of the adventitial vasa vasorum. Late phase CEUS detect inflammation by visualizing microbubbles phagocytosed by monocytes. The inflammatory process of the vessel wall associated with perivascular angiogenesis at the time of deep venous thrombosis (DVT) and superficial vein thrombophlebitis (SVT) may important in the development of post-thrombotic syndrome (PTS). Therefore the investigators will test the value of CEUS to detect venous perivascular vascularization and inflammation in patients with acute DVT or SVT.
Aims:
To determine the presence and degree of venous perivascular vascularization and inflammation assessed with CEUS in patients with acute DVT or SVT, and compare this to controls without thrombosis.
Expected results:
The investigators hypothesize that venous perivascular vascularization and inflammation assessed by contrast agent enhancement can be quantified and will be significantly more pronounced in the perivascular tissue of the thrombotic vein than in the non affected vein and in controls, and will correlate with level of inflammatory markers and leg volume.
Significance:
These results would provide new information on the pathophysiological concept of thrombosis and thrombus resolution. It might help to better understand the pathophysiologic mechanisms that promote the development of chronic venous insufficiency and PTS.
| Condition | Intervention |
|---|---|
|
Thrombosis |
Other: No intervention |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Evaluation of Perivascular Venous Vascularization and Inflammation by Contrast-enhanced Ultrasound (CEUS) in Patients With Acute Deep Vein Thrombosis and Superficial Thrombophlebitis - a Pilot Study |
- Venous perivascular vascularization and inflammation [ Time Frame: At baseline, 2 weeks, and 3 months ] [ Designated as safety issue: No ]Venous perivascular vascularization and inflammation assessed by contrast-enhanced ultrasound
- Inflammatory markers [ Time Frame: At baseline, 2 weeks, and 3 months ] [ Designated as safety issue: No ]Interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant-1 (MCP-1), Vascular cellular adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF) and C-reactive protein (CRP)
- Edema of the lower extremity [ Time Frame: At baselin, 2 weeks, and 3 months ] [ Designated as safety issue: No ]Quantitative volume measurement of the legs will be performed using an automated 3D image measurement system (Bauerfeind®, Zeulenroda-Triebes, Germany).
Biospecimen Retention: Samples Without DNA
The investigators will also determine level of inflammatory markers as the cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), monocyte chemoattractant-1 (MCP-1), Vascular cellular adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF) and C-reactive protein (CRP) at each visit (baseline, 2 weeks, and 3 months).
| Estimated Enrollment: | 40 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | August 2014 |
| Estimated Primary Completion Date: | March 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Thrombosis
Patients with acute, idiopathic or provoked, unilateral proximal DVT (involving the popliteal vein or further proximal veins) and SVT of the lower-extremity detected with duplex ultrasound. Age and sex matched controls (volunteers) |
Other: No intervention
There will be no intervention in this study.
Other Name: No intervention
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Probability Sample |
20 patients with unilateral proximal DVT and 10 patients with SVT of the lower-extremity will be included in this study. As control, 10 volunteers without DVT or SVT, and without history of thromboembolism, will be recruited.
Inclusion Criteria:
- Age greater than 18 years
- acute, idiopathic or provoked, unilateral proximal DVT (involving the popliteal vein or further proximal veins)
- SVT (more than 5cm in length on compression ultrasonography) of the lower- extremity
- Age and sex matched controls will be recruited from volunteers after exclusion of DVT or SVT, and without history of thrombosis and pulmonary embolism
Exclusion Criteria:
- History of previous DVT or SVT of the lower-extremity
- History of pulmonary embolism
- Bilateral DVT or SVT
- DVT associated with intravenous drug abuse, surgery of the lower-extremity in the previous 10 days, or sclerotherapy in the previous 30 days
- Follow-up is not considered feasible
- Heart failure (HYHA III or IV)
- Acute coronary syndrome (<7d)
- Severe pulmonal-arterial hypertension (pulmonal arterial pressure >90mmHg)
- Pregnancy
Contacts and Locations| Contact: Daniel Staub, MD | 61 328 6152 ext ++41 | staubd@uhbs.ch |
| Switzerland | |
| University Hospital Basel | Recruiting |
| Basel, Switzerland, 4031 | |
| Contact: Daniel Staub, MD 61 328 6152 ext ++41 staubd@uhbs.ch | |
| Principal Investigator: Daniel Staub, MD | |
| Principal Investigator: | Daniel Staub, MD | Unversity Hospital, Basel, Switzerland |
More Information
Publications:
| Responsible Party: | University Hospital, Basel, Switzerland |
| ClinicalTrials.gov Identifier: | NCT01367769 History of Changes |
| Other Study ID Numbers: | DMS2154 |
| Study First Received: | June 3, 2011 |
| Last Updated: | October 24, 2012 |
| Health Authority: | Switzerland: Ethikkommission |
Keywords provided by University Hospital, Basel, Switzerland:
|
Deep vein thrombosis superficial thrombophlebitis contrast ultrasound |
Additional relevant MeSH terms:
|
Inflammation Neovascularization, Pathologic Thrombophlebitis Thrombosis Venous Thrombosis Pathologic Processes Metaplasia |
Embolism and Thrombosis Vascular Diseases Cardiovascular Diseases Phlebitis Peripheral Vascular Diseases Vasculitis |
ClinicalTrials.gov processed this record on May 19, 2013