NCT06672081

Brief Summary

Prospective, multicenter, open label, randomized controlled clinical trial to compare the effects of an early catheter-directed treatment plus conventional care with conventional care in patients with high-risk pulmonary embolism

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
210

participants targeted

Target at P75+ for not_applicable

Timeline
14mo left

Started Dec 2024

Typical duration for not_applicable

Geographic Reach
1 country

18 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress54%
Dec 2024Jun 2027

First Submitted

Initial submission to the registry

November 1, 2024

Completed
3 days until next milestone

First Posted

Study publicly available on registry

November 4, 2024

Completed
2 months until next milestone

Study Start

First participant enrolled

December 27, 2024

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2027

Last Updated

March 4, 2026

Status Verified

March 1, 2026

Enrollment Period

2.5 years

First QC Date

November 1, 2024

Last Update Submit

March 3, 2026

Conditions

Keywords

pulmonary embolismearly catheter-directed treatment

Outcome Measures

Primary Outcomes (1)

  • Composite endpoint of mortality (all-cause) and recurrent cardiac arrest or persistent / recurrent shock

    1. mortality (all-cause) up to 7 days after randomization and 2. either one of the following 1. recurrent cardiac arrest or 2. persistent / recurrent shock (systolic BP \<90 mmHg or vasopressors or ECMO required to achieve a systolic BP ≥90 mmHg, in combination with end-organ hypoperfusion (cold, clammy skin, oliguria or serum lactate ≥2 mmol/L) 24 hours after randomization

    7 days

Secondary Outcomes (9)

  • All-cause mortality

    7 days

  • PE-related mortality

    7 days

  • Mortality (all-cause)

    30 days

  • Bail out therapy

    7 days

  • GUSTO moderate or severe bleeding

    7 days

  • +4 more secondary outcomes

Study Arms (2)

conventional care

ACTIVE COMPARATOR

Patients in the conventional care group will receive guideline directed therapy including reperfusion treatment. If no clinically relevant hemodynamic improvement occurs, catheter-interventional treatment may be used as stated in the current ESC-guidelines

Drug: Conventional care

Early Catheter-Interventional Treatment + conventional care

EXPERIMENTAL

Patients in this group will undergo a catheter-interventional treatment within 60 min. after randomization. Fibrinolytic treatment will be prepared parallel to interventional treatment preparations to avoid any delay in its administration, if clinically necessary. Catheter-interventional treatment may include any certified devices for the treatment of PE including aspiration thrombectomy, local fibrinolytic therapy, local ultrasound treatment as assistance to local fibrinolysis or any combination of these. Transfemoral venous access routes will be used for any catheter-directed treatment using sheath-sizes as recommended in the IFUs by the respective manufacturers. Sheaths will be withdrawn immediately after catheter-based thrombectomy or after completion of catheter-directed local fibrinolysis, typically 5 to 10 hours after initiation. The choice of the catheter types and sizes will be left to the treating interventionalists' discretion.

Procedure: Early Catheter-Interventional TreatmentDrug: Conventional care

Interventions

reperfusion treatment

Early Catheter-Interventional Treatment + conventional careconventional care

Patients will undergo a catheter-interventional treatment within 60 min. after randomization. Fibrinolytic treatment will be prepared parallel to interventional treatment preparations to avoid any delay in its administration if clinically necessary. Catheter-interventional treatment may include any certified devices for the treatment of PE including aspiration thrombectomy, local fibrinolytic therapy, local ultrasound treatment as assistance to local fibrinolysis or any combination of these.Transfemoral venous access routes will be used for any catheter-directed treatment using sheath-sizes as recommended in the IFUs by the respective manufacturers. Sheaths will be withdrawn immediately after catheter-based thrombectomy or after completion of catheter-directed local fibrinolysis, typically 5 to 10 hours after initiation.

Early Catheter-Interventional Treatment + conventional care

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Pulmonary embolism as confirmed by CT angiogram with high mortality risk as defined by ESC guidelines:
  • a) One of the following: i. Cardiac arrest or ii. obstructive shock (systolic BP \<90 mmHg or vasopressors required to achieve a BP ≥90 mmHg despite an adequate filling status), in combination with end-organ hypoperfusion (cold, clammy skin, oliguria or serum lactate ≥2 mmol/L) and b) Signs of right-ventricular dysfunction on transthoracic echocardiogram or CT scan
  • Age ≥18 years

You may not qualify if:

  • Contraindications for catheter-based treatment
  • Contraindications to systemic fibrinolytic treatment or anticoagulation\*
  • Active, potentially life-threatening bleeding
  • Surgery within 24h before screening
  • Cranial or spinal surgery within 14d before screening
  • Stroke within 14d before screening
  • Intracranial tumor
  • Any condition not listed here but estimated as clinically relevant as judged by the treating investigator
  • Pregnancy
  • Patients with contraindications to systemic fibrinolysis or anticoagulation can be enrolled in a third study arm (registry) and undergo catheter-directed therapy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (18)

Universitätsklinikum Freiburg

Bad Krozingen, 79189, Germany

RECRUITING

Oberlausitzklinikum Bautzen, Medizinische Klinik I

Bautzen, 02625, Germany

RECRUITING

Universitätsklinikum Bonn

Bonn, 53127, Germany

RECRUITING

Universitätsklinik Düsseldorf, Klinik für Kardiologie, Pneumologie und Angiologie

Düsseldorf, 40225, Germany

RECRUITING

HELIOS Klinikum Erfurt

Erfurt, 99089, Germany

RECRUITING

Universitätsklinikum Frankfurt, Med. Klinik III - Kardiologie, Angiologie

Frankfurt am Main, 60590, Germany

RECRUITING

Universitätsklinikum Halle

Halle, 06120, Germany

RECRUITING

Asklepios Klinik St. Georg

Hamburg, 20099, Germany

RECRUITING

SLK-Kliniken Heilbronn

Heilbronn, 74078, Germany

RECRUITING

Westpfalz-Klinikum GmbH, Klinik für Innere Medizin 2

Kaiserslautern, 67655, Germany

RECRUITING

Universitätsklinikum Leipzig

Leipzig, 04103, Germany

RECRUITING

Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology

Leipzig, 04289, Germany

RECRUITING

Universitätsklinikum Mannheim

Mannheim, 68167, Germany

RECRUITING

Klinik für Innere Medizin 8 Schwerpunkt Kardiologie Universitätsklinik der Paracelsus Medizinischen Privatuniversität Klinikum Nürnberg I Campus Süd

Nuremberg, 90471, Germany

RECRUITING

Bundeswehrkrankenhaus Ulm, Abteilung I - Innere Medizin, Schwerpunkt Kardiologie

Ulm, 89081, Germany

RECRUITING

Schwarzwald-Baar-Klinikum

Villingen-Schwenningen, 78052, Germany

RECRUITING

Rems-Murr-Kliniken

Winnenden, 71364, Germany

RECRUITING

Helios Kliniken Wuppertal

Wuppertal, 42117, Germany

RECRUITING

MeSH Terms

Conditions

Pulmonary Embolism

Condition Hierarchy (Ancestors)

Lung DiseasesRespiratory Tract DiseasesEmbolismEmbolism and ThrombosisVascular DiseasesCardiovascular Diseases

Study Officials

  • Karl Fengler, MD, Assoc. Prof.

    Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology

    STUDY CHAIR
  • Holger Thiele, MD. Prof.

    Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology

    STUDY CHAIR

Central Study Contacts

Karl Fengler, MD, Assoc. Prof.

CONTACT

Holger Thiele, MD, Prof. Dr.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 1, 2024

First Posted

November 4, 2024

Study Start

December 27, 2024

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

June 30, 2027

Last Updated

March 4, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will not share

Locations