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Acute Pulmonary EmbolismEarly Phase 1NCT07032025

Mechanical Thrombectomy for Acute Pulmonary Embolism

A Early Phase 1 study testing Innovative Device Group and Standard Pharmacological Therapy Group in people with Acute Pulmonary Embolism, run by RenJi Hospital.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Official record
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Trial summary

Research Objective: To prospectively compare the efficacy and safety of a pre-collaboratively developed ultra-thin PTFE minimally invasive thrombectomy system versus standard pharmacological therapy in patients with acute pulmonary embolism (PE), both administered on top of standard care. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Acute Pulmonary Embolism
What is being tested?
Innovative Device Group and Standard Pharmacological Therapy Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
No sites listed yet
Study dates
1 Jul 2025to 1 Jul 2027
Phase
Early Phase 1
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18-75 years (male or female)
  • Clinically diagnosed with acute PE
  • Right ventricular/left ventricular diameter ratio (RV/LV) ≥0.9 on computed tomographic pulmonary angiography (CTPA)
  • Provision of voluntary written informed consent.

Who cannot join

  • Target vessel diameter <6 mm
  • Calcification, plaque, or stenosis in target lesion
  • Sustained systolic blood pressure <90 mmHg for >15 minutes or requiring vasopressors to maintain SBP ≥90 mmHg
  • Peak pulmonary artery pressure >70 mmHg
  • Hematocrit <28%
  • History of chronic pulmonary hypertension
Show all 21Show fewer
  • Pre-existing left bundle branch block
  • Chronic left heart failure with left ventricular ejection fraction (LVEF) ≤30%
  • Renal dysfunction (serum creatinine >1.8 mg/dL or >159 μmol/L)
  • Known coagulopathy or bleeding diathesis:
  • Platelet count <50×10⁹/L, or International Normalized Ratio (INR) >3
  • Contraindications to antiplatelet/anticoagulant therapy
  • Cardiothoracic or pulmonary surgery within 7 days prior
  • Intracardiac thrombus
  • Patients on extracorporeal membrane oxygenation (ECMO)
  • Known hypersensitivity to iodinated contrast media
  • Significant comorbidities complicating treatment/evaluation:
  • Active malignancy Acute infectious disease/sepsis Systemic conditions precluding procedure tolerance Life expectancy <1 year
  • Pregnant or lactating women
  • Concurrent participation in other drug/device trials
  • Other investigator-determined unsuitability

About this study

Official title: A Prospective, Multicenter, Randomized Controlled Trial of the Catheter-directed Mechanical Thrombectomy Compared to Standard Anticoagulation for Use in the Treatment of Acute Intermediate-risk Pulmonary Embolism.

Research Objective:

To prospectively compare the efficacy and safety of a pre-collaboratively developed ultra-thin PTFE minimally invasive thrombectomy system versus standard pharmacological therapy in patients with acute pulmonary embolism (PE), both administered on top of standard care.

Read more

Research Content:

Patients meeting all the following criteria will be enrolled:

Aged 18-75 years (male or female)

Clinically diagnosed with acute PE

Right ventricular/left ventricular diameter ratio (RV/LV) ≥0.9 on computed tomographic pulmonary angiography (CTPA)

Provision of voluntary written informed consent.

Study Design:

After confirming eligibility, subjects will be randomized at a 1:1 ratio into two groups:

Innovative Device Group: Minimally invasive thrombectomy

Standard Pharmacological Therapy Group: Pharmacological thrombolysis + anticoagulation

Study Endpoints:

Primary Efficacy Endpoint:

Reduction in RV/LV ratio (measured by CTPA) from baseline to 48 hours post-treatment.

Primary Safety Endpoint:

Incidence of Major Adverse Events (MAEs) from baseline to 48 hours post-treatment, defined as:

Procedure-related death

Major bleeding (per VARC-2 criteria: life-threatening, disabling, or major bleeding)

Treatment-related clinical deterioration, including:

Unplanned mechanical ventilation

Arterial hypotension (systolic blood pressure <90 mmHg for >1 hour or requiring vasopressors) or shock

Cardiopulmonary resuscitation

Sustained deterioration in oxygenation

Emergency surgical embolectomy.

Key Terminology Notes:

RV/LV: Right Ventricular/Left Ventricular diameter ratio (standard medical abbreviation retained).

VARC-2: Valve Academic Research Consortium-2 (internationally recognized bleeding criteria).

PTFE: Polytetrafluoroethylene (material name preserved).

MAE: Major Adverse Events (acronym defined at first use).

Clinical deterioration: Explicitly specified with objective clinical indicators.

This translation maintains scientific precision while adhering to international clinical trial reporting standards (ICH-GCP). The structure aligns with typical English-language study protocols for clarity and reproducibility.

Read the detailed description
  1. Research Objective To prospectively evaluate the comparative efficacy and safety of a novel ultra-thin polytetrafluoroethylene (PTFE) minimally invasive thrombectomy system versus guideline-directed pharmacological thrombolysis in patients with acute intermediate-high-risk pulmonary embolism (PE), both administered as adjuncts to standard anticoagulation therapy.
  2. Study Population Inclusion Criteria: Adults aged 18-75 years (all genders) Acute PE confirmed by computed tomographic pulmonary angiography (CTPA) within 14 days of symptom onset Right ventricular dysfunction defined as RV/LV diameter ratio ≥0.9 on baseline CTPA Provision of written informed consent Exclusion Criteria: Absolute contraindications to thrombolysis (e.g., active bleeding, recent intracranial hemorrhage, major surgery within 14 days) Hemodynamic instability requiring immediate rescue therapy (systolic BP <90 mmHg with end-organ hypoperfusion) Severe renal impairment (eGFR <30 mL/min/1.73m²) or hepatic failure (Child-Pugh Class C) Life expectancy <6 months due to non-PE comorbidities
  3. Study Design Design: Prospective, multicenter, open-label, randomized controlled trial with blinded endpoint adjudication Randomization: Eligible subjects stratified by PE severity (RV/LV: 0.9-1.0 vs. >1.0) and thrombus burden (main/lobar vs. segmental PA involvement), then randomized 1:1 via centralized web-based system. Intervention Groups: Group A (Innovative Device): Ultra-thin PTFE thrombectomy catheter deployed under fluoroscopic guidance via femoral access Procedure completion within 90 minutes; mandatory peri-procedural unfractionated heparin (target ACT 250-300 s) Post-procedure: Enoxaparin 1 mg/kg BID → transitioned to rivaroxaban 20 mg OD at 24 hours Group B (Standard Therapy): Alteplase infusion: 10 mg bolus + 90 mg over 2 hours (max 100 mg) Concurrent heparin infusion (target aPTT 60-80 s) → switched to rivaroxaban 15 mg BID (Day 1-21) → 20 mg OD thereafter
  4. Endpoint Definitions Primary Efficacy Endpoint Absolute reduction in RV/LV ratio from baseline to 48 hours post-intervention, measured by blinded core-lab CTPA analysis. Primary Safety Endpoint Composite Major Adverse Events (MAEs) within 48 hours, including: Procedure-related mortality Major bleeding per VARC-2 criteria: Fatal bleeding Intracranial hemorrhage Bleeding causing ≥3 g/dL hemoglobin drop or transfusion of ≥2 units Bleeding requiring surgical intervention Treatment-related clinical deterioration: Unplanned mechanical ventilation Sustained hypotension (SBP <90 mmHg for >1 hour requiring vasopressors) Cardiopulmonary resuscitation New requirement for ECMO or emergency surgical embolectomy
  5. Statistical Analysis Plan Sample Size: 142 subjects/group (total N=284) providing 90% power (α=0.05) to detect: Efficacy: Mean RV/LR reduction difference of 0.15 (SD=0.3) Safety: 40% relative risk reduction in MAEs (Group A: 10% vs. Group B: 17%) Analysis Sets: Primary analysis: Modified intention-to-treat (mITT; all randomized receiving ≥1 treatment component) Safety analysis: As-treated population Methods: Continuous variables: Mixed-effects repeated measures ANOVA Categorical variables: Cochran-Mantel-Haenszel test with stratification adjustment Time-to-event: Kaplan-Meier with log-rank test
  6. Quality Assurance Endpoint Adjudication Committee: Blinded to treatment allocation

Data Monitoring: Independent DSMB reviewing unblinded safety data quarterly

Procedure Standardization:

All interventionalists certified via simulation training (≥5 proctored cases)

Centralized core lab for CTPA RV/LV measurements

Ethical Compliance: Approved by institutional review boards at all sites (NCT# pending). Trial conducted per Declaration of Helsinki.

Key Advantages of Expanded Protocol Stratified randomization controls confounding from baseline RV strain heterogeneity.

VARC-2 bleeding criteria enhance comparability with cardiovascular intervention trials.

Core-lab blinded CTPA analysis eliminates measurement bias in efficacy assessment.

Pre-specified safety triggers (e.g., Hb drop thresholds) enable objective MAE classification.

Standardized anticoagulation bridging minimizes post-procedural thrombotic risk variability.

Being tested
Innovative Device Group, Standard Pharmacological Therapy Group
Keywords
Prospective Studies, Pulmonary Embolism, Thrombectomy
Medical subject headings
Pulmonary Embolism

What participants receive

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

  • Innovative Device GroupProcedure or surgery

    Catheter-based thrombectomy is performed within 4 hours after baseline CTPA acquisition. Pre-procedural anticoagulation with either low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) is administered prior to thrombectomy. Post-procedural oral anticoagulation is transitioned to rivaroxaban 20 mg once daily (QD).

  • Standard Pharmacological Therapy GroupDrug

    Following thrombolytic agent administration, anticoagulation with rivaroxaban is initiated and maintained at 15 mg twice daily (BID) for the initial 3 weeks, then switched to 20 mg once daily (QD) thereafter.

Study groups in NCT07032025
Study groupRoleWhat they receive
Innovative Device Group: Minimally invasive thrombectomyExperimentalNot described
Receives: Procedure: Innovative Device Group
Standard Pharmacological Therapy Group: Pharmacological thrombolysis + anticoagulationActive comparatorNot described
Receives: Drug: Standard Pharmacological Therapy Group

What is being measured

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

  1. Primary Efficacy Endpoint

    Reduction in RV/LV ratio (measured by CTPA) from baseline to 48 hours post-treatment.

    Measured: 48 hours post-treatment.

  2. Primary Safety Endpoint:

    Incidence of Major Adverse Events (MAEs) from baseline to 48 hours post-treatment

    Measured: 48 hours post-treatment

Timeline

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

  1. First posted22 Jun 2025
  2. Study start1 Jul 2025 (estimated)
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Jul 2027 (estimated)

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
Early Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07032025
Sponsor's protocol ID
EARLY-MYO-PE
Status last verified
Jun 2025
First submitted
13 Jun 2025
Last updated
22 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Wang C, Fang P, Zhou D, Xu B, Dai X, Zhang Z, Xie M, Duan Z, Zhang L, Li Y, Zhu Y, Jiang Y, Qie L, Shi H, Feng J, Zhang W, Jin X. Multi-center Randomized Controlled Trial of Catheter-Directed Mechanical Thrombectomy Versus Systemic Thrombolysis in Patients with Acute Intermediate-to-High-Risk Pulmonary Embolism: Study Protocol. Cardiovasc Intervent Radiol. 2026 Jun;49(6):1210-1218. doi: 10.1007/s00270-026-04433-3. Epub 2026 Apr 29.

    PubMed 42056311

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing Innovative Device Group and Standard Pharmacological Therapy Group in people with Acute Pulmonary Embolism, run by RenJi Hospital.

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 4 inclusion and 21 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: opening soon, as of the sponsor's last update on 22 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

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.

What does this phase mean?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

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?

Primary Efficacy Endpoint (time frame: 48 hours post-treatment.). The study lists 2 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 NCT07032025, which also lists 1 linked publication.

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 22 Jun 2025.

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