Pulsatile TinnitusINVENTNCT05679271
Dural Sinus Stenting of Low Grade Dural Arteriovenous Fistulae (DAVF) for Pulsatile Tinnitus Treatment
A study testing Venous stenting in people with Pulsatile Tinnitus, run by University Hospital, Bordeaux at 1 site in France.
Trial summary
The goal of this randomized trial to assess the angiographic efficacy of venous stenting in dural arteriovenous fistulae (DAVF) via improvment on Cognard's Classification as compared to no intervention at 6 months Participants belonging to experimental group will be treated using venous stenting. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pulsatile Tinnitus
- What is being tested?
- Venous stenting
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 48 participants
- Where
- 1 siteFrance
- Study dates
- 22 Aug 2024to Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient presenting invalidating pulsatile tinnitus
- Patient presenting with PT anatomically correlated with a DAVF
- Type I or IIa DAVF on digital subtraction angiography (DSA), according to Cognard's classification.
- DAVF located on sigmoid , lateral or posterior longitudinal sinus.
- Fistula length compatible with use of up to two stents
- Highly effective contraception for women of childbearing potential, maintained during research procedures
- Affiliated or beneficiary of health insurance
- Signed informed consent
Who cannot join
- Patient with DAVF not eligible for endovascular treatment .
- DAVF classification of IIb or more according to Cognard's classification.
- DAVF with severe sinus stenosis or occlusion judged as nor eligible for sinus stenting.
- DAVF showing evidence of recent (inferior to 3 months) thrombophlebitis at the site of fistulous dural sinus.
- Patient with DAVF previously treated with surgery or radiotherapy.
- Patient with multiple DAVF
Show all 20Show fewer
- Controlateral sinus aplasia or occlusion
- Patient presenting contra-indication to the use of LEA according to the instructions For Use.
- Patient participating in another clinical study evaluating another medical device,
- Any condition or any situation that would prohibit the patient from coming to the investigational center for the follow-up as recommended by the study protocol at 6 months.
- Patient with any known allergy to heparin, acetylsalicylic acid, Coumadin , Warfarin or other antiplatelet medications
- Patient has undergone a surgery including endovascular procedures in the last 30 days prior to the study procedure.
- Patient has had an Intracranial hemorrhage and/or subarachnoid hemorrhage in the past 30 days prior to the study procedure
- Known serious sensitivity to radiographic contrast agents.
- Known sensitivity to nickel, titanium metals, or their alloys
- Known renal failure as defined by a serum creatinine > 2.5 mg/dl (or 220 μmol/l) or glomerular filtration rate (GFR) < 30.
- Patient who has a contraindication to MRI or angiography for whatever reason
- Women who are pregnant, lactating, or who are planning to become pregnant during the anticipated study period
- Patient unable to understand the nature, risks, significance and implications of the clinical investigation or unwilling to provide written informed consent
- Patient under legal protection
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
France1 site, 1 recruiting
- Recruiting
CHU Bordeaux
Bordeaux
Xavier Barreau, MD, 33556795604, xavier.barreau@chu-bordeaux.fr
About this study
Official title: Intracranial Dural Arteriovenous Fistula Related Pulsatile Tinnitus . Endovascular Treatment by Venous Stenting : An Efficacy Study
The goal of this randomized trial to assess the angiographic efficacy of venous stenting in dural arteriovenous fistulae (DAVF) via improvment on Cognard's Classification as compared to no intervention at 6 months Participants belonging to experimental group will be treated using venous stenting. DAVF will be assessed by angiography at 6 months follow-up. Participants belonging to control group will be followed accordingly to standard of care (no treatment). After 6 months, control group patients can be treated by any means accordinlgly to standard of care.
Read the detailed description
DAVF are frequently revealed as a cause of invalidating pulsatile tinnitus (PT). Endovascular treatment (EVT) of DAVF using liquid embolic agent (LEA) is currently performed when an hemorrhagic risk of intracranial hemorrhage is identified (high grade DAVF). PT alone may not be a sufficient condition to offer EVT because procedure-related risks may overcome clinical benefits specifically in case of extended shunts requiring complex procedures. Stenting of dural sinus may represent an alternative to LEA-EVT with a simple and low risk procedure. Thus PT could be cured even in case of low grade DAVF without neurologic risk.
- Conditions
- Pulsatile Tinnitus
- Being tested
- Venous stenting, Standard of care
- Keywords
- Dural arteriovenous fistulae, Pulsatile tinnitus, Venous Stenting
- Medical subject headings
- Tinnitus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Venous stentingDevice
venous stenting associated to antiaggregation protocol
Standard of careOther
observation: no treatment
| Study group | Role | What they receive |
|---|---|---|
| venous stenting | Experimental | Venous stenting associated to antiaggregation protocol:
Venous stenting: venous approach can be performed via femoral, brachial or jugular puncture. Autoexpansible stent should delivered at the level of the fistulous sinus. If distal access catheter is wide enough, stent can be delivered directly through it. After partial deployment of the stent, Labbe vein's flow may be restricted. If necessary, several stents can be used in the same procedure to cover the whole length of fistulous sinus area. After stent deployment, ballon angioplasty is compulsory and must be performed using a ballon of equivalent size to the stent. The procedure ends after stent deployment and angiographic arterial post-op controls.
Antiaggregation protocol: aspirin (160mg for 3 months) + clopidogrel (75mg/d 5 days before stenting and 75mg/d for 1 month after stenting) OR ticagrelor (180mg 2h before stenting and 90mg twice a day for 1 month) in case of clopidogrel platelet resistance. Receives: Device: Venous stenting |
| no treatment | Active comparator | standard care (no treatment) Receives: Other: Standard of care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Cognard's classification grade
Cognard's classification status : from type I (Anterograde drainage into venous sinus) to Type V (Drainage into the spinal perimedullary veins)
Measured: Month 6
Secondary outcomes (8)
THI score
THI (Tinnitus Handicap Inventory) score (based on 100 points scale from Grade 1 (<16 points) Slight or no handicap to Grade 5 (>=78 points) Catastrophic handicap)
Measured: Baseline, Month 6, Month 12, Month 24
modified Rankin Scale
mRS Neurological score (from 0 - No symptoms at all to 6 - Death)
Measured: Baseline, Month 6
Rate of stent thrombosis
Rate of stent thrombosis
Measured: Month 6, Month 12, Month 24
unsuccessful stent deployment
Rate of unsuccessful stent deployment
Measured: Baseline
Concentration troubles
Assessment via Visual Analog Scale from 0-no trouble to 10-extreme troubles
Measured: Baseline, Month 6, Month 12, Month 24
Sleep troubles
Assessment via Visual Analog Scale from 0-no trouble to 10-extreme troubles
Measured: Baseline, Month 6, Month 12, Month 24
Headaches
Assessment via Visual Analog Scale from 0-no trouble to 10-extreme troubles
Measured: Baseline, Month 6
Dizziness
Assessment via Visual Analog Scale from 0-no trouble to 10-extreme troubles
Measured: Baseline, Month 6, Month 12, Month 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Jan 2023
- Study start22 Aug 2024
- Primary completionDec 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Pulsatile TinnitusStudies of the same condition, open and under way.
- More trials run by University Hospital, BordeauxThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- None (open label)
- Enrolment
- 48 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University Hospital, Bordeaux
- Sponsor type
- University, hospital or other
- Collaborators
- Ministry of Health, France
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05679271
- Sponsor's protocol ID
- CHUBX 2022/20
- Acronym
- INVENT
- Status last verified
- Feb 2025
- First submitted
- 28 Dec 2022
- Last updated
- 11 Feb 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Intracranial Dural Arteriovenous Fistula Related Pulsatile Tinnitus . Endovascular Treatment by Venous Stenting : An Efficacy Study
- ClinicalTrials.gov ID
- NCT05679271
- Acronym / sponsor ID
- INVENT / CHUBX 2022/20
- Conditions
- Pulsatile Tinnitus
- Keywords
- Dural arteriovenous fistulae, Pulsatile tinnitus, Venous Stenting
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 48 participants (estimated)
- Lead sponsor
- University Hospital, BordeauxUniversity, hospital or other
- Collaborators
- Ministry of Health, France
- Study start
- 22 Aug 2024 (actual)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 10 Jan 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this randomized trial to assess the angiographic efficacy of venous stenting in dural arteriovenous fistulae (DAVF) via improvment on Cognard's Classification as compared to no intervention at 6 months Participants belonging to experimental group will be treated using venous stenting. DAVF will be assessed by angiography at 6 months follow-up. Participants belonging to control group will be followed accordingly to standard of care (no treatment). After 6 months, control group patients can be treated by any means accordinlgly to standard of care.
Detailed description
DAVF are frequently revealed as a cause of invalidating pulsatile tinnitus (PT). Endovascular treatment (EVT) of DAVF using liquid embolic agent (LEA) is currently performed when an hemorrhagic risk of intracranial hemorrhage is identified (high grade DAVF). PT alone may not be a sufficient condition to offer EVT because procedure-related risks may overcome clinical benefits specifically in case of extended shunts requiring complex procedures. Stenting of dural sinus may represent an alternative to LEA-EVT with a simple and low risk procedure. Thus PT could be cured even in case of low grade DAVF without neurologic risk.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| venous stenting | Experimental | Device: Venous stentingVenous stenting associated to antiaggregation protocol: Venous stenting: venous approach can be performed via femoral, brachial or jugular puncture. Autoexpansible stent should delivered at the level of the fistulous sinus. If distal access catheter is wide enough, stent can be delivered directly through it. After partial deployment of the stent, Labbe vein's flow may be restricted. If necessary, several stents can be used in the same procedure to cover the whole length of fistulous sinus area. After stent deployment, ballon angioplasty is compulsory and must be performed using a ballon of equivalent size to the stent. The procedure ends after stent deployment and angiographic arterial post-op controls. Antiaggregation protocol: aspirin (160mg for 3 months) + clopidogrel (75mg/d 5 days before stenting and 75mg/d for 1 month after stenting) OR ticagrelor (180mg 2h before stenting and 90mg twice a day for 1 month) in case of clopidogrel platelet resistance. |
| no treatment | Active comparator | Other: Standard of carestandard care (no treatment) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Patient presenting invalidating pulsatile tinnitus
- Patient presenting with PT anatomically correlated with a DAVF
- Type I or IIa DAVF on digital subtraction angiography (DSA), according to Cognard's classification.
- DAVF located on sigmoid , lateral or posterior longitudinal sinus.
- Fistula length compatible with use of up to two stents
Key exclusion criteria (20 listed)
- Patient with DAVF not eligible for endovascular treatment .
- DAVF classification of IIb or more according to Cognard's classification.
- DAVF with severe sinus stenosis or occlusion judged as nor eligible for sinus stenting.
- DAVF showing evidence of recent (inferior to 3 months) thrombophlebitis at the site of fistulous dural sinus.
- Patient with DAVF previously treated with surgery or radiotherapy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Venous stentingvenous stenting associated to antiaggregation protocol | Device | venous stenting |
| Standard of careobservation: no treatment | Other | no treatment |
Primary outcome
Cognard's classification grade
Time frame: Month 6
Cognard's classification status : from type I (Anterograde drainage into venous sinus) to Type V (Drainage into the spinal perimedullary veins)
8 secondary outcomes
THI score
Time frame: Baseline, Month 6, Month 12, Month 24
modified Rankin Scale
Time frame: Baseline, Month 6
Rate of stent thrombosis
Time frame: Month 6, Month 12, Month 24
unsuccessful stent deployment
Time frame: Baseline
Concentration troubles
Time frame: Baseline, Month 6, Month 12, Month 24
Sleep troubles
Time frame: Baseline, Month 6, Month 12, Month 24
Headaches
Time frame: Baseline, Month 6
Dizziness
Time frame: Baseline, Month 6, Month 12, Month 24
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Feb 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Venous stenting in people with Pulsatile Tinnitus, run by University Hospital, Bordeaux at 1 site in France.
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 8 inclusion and 20 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: looking for participants now, as of the sponsor's last update on 11 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. 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. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Xavier BARREAU, MD (+33 556 79 56 04, xavier.barreau@chu-bordeaux.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Cognard's classification grade (time frame: Month 6). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 11 Feb 2025.