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Multiple SclerosisNCT01201707

Evaluation of Angioplasty in the Treatment of Chronic Cerebrospinal Venous Insufficiency (CCSVI) in Multiple Sclerosis

A study testing Angioplasty and Observation in people with Multiple Sclerosis, run by Community Care Physicians, P.C. at 2 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The study is being done to determine if venous angioplasty is an effective treatment for chronic cerebrospinal venous insufficiency (CCSVI). In this condition, areas of narrowing or blockages are present in the internal jugular or azygos veins (veins which drain blood from the central nervous system) and these… Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Multiple Sclerosis
What is being tested?
Angioplasty and Observation
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
2 sitesUnited States
Study dates
Aug 2010to Sep 2013
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Patients who are willing to comply with the protocol requirements and can be contacted by telephone
  • Patients 18-60 years of age
  • Patients with clinically definite multiple sclerosis by Polman criteria
  • Patients with a history of MS as defined above with an EDSS between 3-6.
  • Patients with a significant stenosis of the internal jugular or azygos vein on the basis of magnetic resonance venography or Doppler ultrasound.

Who cannot join

  • Patients with renal insufficiency based on an estimated GFR <45
  • Patients with a known severe allergy to iodine or gadolinium-based contrast agents which cannot be adequately pre-medicated
  • Patients with a known allergy to nickel
  • Patients who pregnant
  • Patients with a contraindication to anticoagulation or anti-platelet medication
  • Patients with a contraindication to drugs used for conscious sedation during interventional procedures, including Versed and Fentanyl
Show all 11Show fewer
  • Patients with a history of deep venous thrombosis of the lower extremities
  • Patients with occlusion of the right and left common femoral veins
  • Patients who have had any changes in their disease modifying drug regimen for MS during the 6 months prior to enrollment in this trial. This would include the addition of any new medications, a change in the dosage of any medications, or the removal of any medications from a patient's drug regimen
  • Patients with a life expectancy <18 months
  • Patients who are currently enrolled or who plan to enroll in other investigations that conflict with follow-up testing or confounds data in this trial

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Albany Medical Center

    Albany, New York, 12208

  • Image Care Latham

    Latham, New York, 12110

Other trials in United States

About this study

Official title: The Effectiveness of Endovascular Treatment of Chronic Cerebrospinal Venous Insufficiency (CCSVI) in Patients With Multiple Sclerosis

The study is being done to determine if venous angioplasty is an effective treatment for chronic cerebrospinal venous insufficiency (CCSVI). In this condition, areas of narrowing or blockages are present in the internal jugular or azygos veins (veins which drain blood from the central nervous system) and these blockages may be associated with symptoms classically attributed to MS. Therefore, angioplasty may help to improve the symptoms associated with CCSVI and multiple sclerosis (MS). In this study, the investigators will evaluate the effectiveness of angioplasty in the treatment of CCSVI by comparing two the outcomes of two groups of patients: one group with CCSVI diagnosed on a venogram and treated with angioplasty and one group with CCSVI diagnosed on a venogram but not treated. The patients enrolled in this study, and the neurologist evaluating patients after the procedure, will not know whether or not they were treated with angioplasty.

Being tested
Angioplasty, Observation
Keywords
Multiple Sclerosis, Angioplasty, Vein
Medical subject headings
Multiple Sclerosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AngioplastyProcedure or surgery

    In this procedure, a small catheter (tube) that is approximately the size of a piece of spaghetti is introduced into the vein that is narrowed based on the findings of the venogram. This catheter has a small balloon on it. That balloon is inflated across the narrowing within the vein with the goal of increasing the diameter of that vein and improving flow within that vein.

  • ObservationOther

    Patients in this arm will be diagnosed with CCSVI based on venography but will receive no intervention. They will be followed in the same manner as patients treated with angioplasty.

Study groups in NCT01201707
Study groupRoleWhat they receive
Treatment of CCSVI with AngioplastyExperimentalAt the time of venography, these patients will have had a significant lesion (blockage) in the internal jugular and/or the azygos vein that will be treated with angioplasty.
Receives: Procedure: Angioplasty
Observation of CCSVISham comparatorAt the time of venography, these patients will have had a significant lesion (blockage) in the internal jugular and/or the azygos vein that will not be treated with angioplasty. These patients will be observed after treatment and compared to those patients who received treatment.
Receives: Other: Observation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 1 Month

  2. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 3 Months

  3. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 6 Months

  4. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 12 Months

  5. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 18 Months

  6. Impact of CCSVI treatment on quality of life in patients with MS

    This will be assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL-54), which is a health-related quality of life measure that combines generic and MS-specific items into a single, self-report questionnaire.

    Measured: 24 Months

Secondary outcomes (23)
  1. Clinical significance of CCSVI in MS patients

    This will be assessed clinically using annualized relapse rates, Expanded Disability Status Scale (EDSS) change and change in the timed 25 foot walk.

    Measured: 1 month

  2. Superiority of angioplasty to observation for treatment of CCSVI

    This will be assessed clinically using annualized relapse rates, EDSS change, and change in the timed 25-foot walk

    Measured: 1 month

  3. Incidence of CCSVI in patients with MS

    This will be assessed on the basis of the findings on diagnostic venography of the internal jugular and azygos veins, which is the initial procedure performed in these patients.

    Measured: 0 Months

  4. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 1 month

  5. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 1 month

  6. Clinical significance of CCSVI in MS patients

    This will be assessed clinically using annualized relapse rates, EDSS change and change in the timed 25 foot walk.

    Measured: 6 months

  7. Clinical significance of CCSVI in MS patients

    This will be assessed clinically using annualized relapse rates, EDSS change and change in the timed 25 foot walk.

    Measured: 12 months

  8. Clinical significance of CCSVI in MS patients

    This will be assessed clinically using annualized relapse rates, EDSS change and change in the timed 25 foot walk.

    Measured: 18 months

  9. Clinical significance of CCSVI in MS patients

    This will be assessed clinically using annualized relapse rates, EDSS change and change in the timed 25 foot walk.

    Measured: 24 months

  10. Superiority of angioplasty to observation for treatment of CCSVI

    This will be assessed clinically using annualized relapse rates, EDSS change, and change in the timed 25-foot walk

    Measured: 6 Months

  11. Superiority of angioplasty to observation for treatment of CCSVI

    This will be assessed clinically using annualized relapse rates, EDSS change, and change in the timed 25-foot walk

    Measured: 12 Months

  12. Superiority of angioplasty to observation for treatment of CCSVI

    This will be assessed clinically using annualized relapse rates, EDSS change, and change in the timed 25-foot walk

    Measured: 18 Months

  13. Superiority of angioplasty to observation for treatment of CCSVI

    This will be assessed clinically using annualized relapse rates, EDSS change, and change in the timed 25-foot walk

    Measured: 24 Months

  14. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 3 months

  15. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 6 months

  16. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 12 months

  17. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 18 months

  18. Safety of endovascular treatment of CCSVI

    This is defined as the number and nature of any procedure-related adverse effects

    Measured: 24 months

  19. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 3 months

  20. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 6 months

  21. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 12 months

  22. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 18 months

  23. Target vessel primary and secondary patency

    Primary patency is the interval following the initial angioplasty procedure until a reintervention is performed to preserve patency. Secondary patency is defined as the interval following the initial angioplasty procedure until treatment of the vein is abandoned due to an inability to treat the original lesion

    Measured: 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2010 (estimated)
  2. Study startAug 2010
  3. Primary completionSep 2013
  4. Study completionSep 2013

Why it stopped: Inability to enroll adequate number of patients

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01201707
Sponsor's protocol ID
2794
Status last verified
Nov 2013
First submitted
10 Sep 2010
Last updated
26 Nov 2013
Results posted
No
Data monitoring committee
Yes

Publications

  • Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Gianesini S, Bartolomei I, Mascoli F, Salvi F. A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg. 2009 Dec;50(6):1348-58.e1-3. doi: 10.1016/j.jvs.2009.07.096.

    PubMed 19958985
  • Zamboni P, Menegatti E, Weinstock-Guttman B, Schirda C, Cox JL, Malagoni AM, Hojanacki D, Kennedy C, Carl E, Dwyer MG, Bergsland N, Galeotti R, Hussein S, Bartolomei I, Salvi F, Zivadinov R. The severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis is related to altered cerebrospinal fluid dynamics. Funct Neurol. 2009 Jul-Sep;24(3):133-8.

    PubMed 20018140
  • Bartolomei I, Salvi F, Galeotti R, Salviato E, Alcanterini M, Menegatti E, Mascalchi M, Zamboni P. Hemodynamic patterns of chronic cerebrospinal venous insufficiency in multiple sclerosis. Correlation with symptoms at onset and clinical course. Int Angiol. 2010 Apr;29(2):183-8.

    PubMed 20351674
  • Malagoni AM, Galeotti R, Menegatti E, Manfredini F, Basaglia N, Salvi F, Zamboni P. Is chronic fatigue the symptom of venous insufficiency associated with multiple sclerosis? A longitudinal pilot study. Int Angiol. 2010 Apr;29(2):176-82.

    PubMed 20351673
  • Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G, Dall'Ara S, Bartolomei I, Salvi F. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009 Apr;80(4):392-9. doi: 10.1136/jnnp.2008.157164. Epub 2008 Dec 5.

    PubMed 19060024

Questions about this trial

What is this clinical trial studying?

A study testing Angioplasty and Observation in people with Multiple Sclerosis, run by Community Care Physicians, P.C. at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 26 Nov 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Inability to enroll adequate number of patients). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Impact of CCSVI treatment on quality of life in patients with MS (time frame: 1 Month). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01201707, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Nov 2013.

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