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In Vivo Detection of Circulating Clots in Patients With Thromboembolism

Primary Purpose

Thromboembolism

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Photoacoustic Flow Cytometry
Sponsored by
University of Arkansas
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Thromboembolism

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Evidence of current venous or arterial thromboembolic disease diagnosed by standard of care clinical, radiographic, or laboratory testing.

Exclusion Criteria:

  • Treatment with anticoagulant therapy (except aspirin) for longer than 24 hours (within 30 days prior to consideration for inclusion)
  • pulmonary embolus
  • acute coronary syndrome, acute stroke, significant cardiac arrhythmia, intracardiac thrombus, any embolus or thrombus requiring vascular surgery or interventional radiology to attempt acute embolectomy or thrombectomy
  • sickle cell disease
  • sepsis, traumatic injury, pregnancy or breastfeeding
  • severe mental illness

Sites / Locations

  • Univerisity of Arkansas for Medical SciencesRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Procedure

Arm Description

Subjects will receive PAFC procedure

Outcomes

Primary Outcome Measures

Comparison of Circulating blood clots detected by PAFC with D-dimer levels in patients with known venous thromboembolic disease - Positive PA peaks
Measurement of in vivo CBC-associated positive PA peaks in a signal trace of patients who have been diagnosed with conventional methods.
Comparison of Circulating blood clots detected by PAFC with D-dimer levels in patients with known venous thromboembolic disease - Negative PA peaks
Measurement of in vivo CBC-associated negative PA peaks in a signal trace of patients who have been diagnosed with conventional methods.

Secondary Outcome Measures

Relationship between PA peaks and circulating blood clots
PAFC will be compared with the fibrin degradation fragment D-dimer to indicate the presence of a blood clot undergoing dissolution.
Safety of the PAFC method - skin sensitivity
The safety of the PAFC device through estimation of the sensitivity of the individual's skin to laser radiation will be indicated by a possible warming feeling or tingling sensation.
Safety of the PAFC method - change in skin property
The safety of the PAFC device through estimation of the change to the skin's property after laser exposure measured by appearance of possible red spots in the irradiated local area

Full Information

First Posted
February 9, 2022
Last Updated
July 26, 2023
Sponsor
University of Arkansas
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1. Study Identification

Unique Protocol Identification Number
NCT05301348
Brief Title
In Vivo Detection of Circulating Clots in Patients With Thromboembolism
Official Title
In Vivo Detection of Circulating Clots in Patients With Thromboembolism
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 26, 2023 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
January 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Arkansas

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Subjects with thromboembolic disease or at high-risk for thromboembolic conditions diagnosed with ultrasound or other standard of care techniques will be recruited to estimate the feasibility of a device to detect in vivo CBCs.
Detailed Description
There are no current gold standards to detect circulating blood clots. The sensitivity of most current methods to detect CBCs is poor when low numbers are present in the host. A novel method of detecting circulating blood clots, PAFC, may improve detection of CBCs and, if so, ultimately may reduce complications related to previously undetected clots.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Thromboembolism

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Procedure
Arm Type
Experimental
Arm Description
Subjects will receive PAFC procedure
Intervention Type
Device
Intervention Name(s)
Photoacoustic Flow Cytometry
Intervention Description
Detection of circulating blood clots
Primary Outcome Measure Information:
Title
Comparison of Circulating blood clots detected by PAFC with D-dimer levels in patients with known venous thromboembolic disease - Positive PA peaks
Description
Measurement of in vivo CBC-associated positive PA peaks in a signal trace of patients who have been diagnosed with conventional methods.
Time Frame
30 days
Title
Comparison of Circulating blood clots detected by PAFC with D-dimer levels in patients with known venous thromboembolic disease - Negative PA peaks
Description
Measurement of in vivo CBC-associated negative PA peaks in a signal trace of patients who have been diagnosed with conventional methods.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Relationship between PA peaks and circulating blood clots
Description
PAFC will be compared with the fibrin degradation fragment D-dimer to indicate the presence of a blood clot undergoing dissolution.
Time Frame
30 days
Title
Safety of the PAFC method - skin sensitivity
Description
The safety of the PAFC device through estimation of the sensitivity of the individual's skin to laser radiation will be indicated by a possible warming feeling or tingling sensation.
Time Frame
30 days
Title
Safety of the PAFC method - change in skin property
Description
The safety of the PAFC device through estimation of the change to the skin's property after laser exposure measured by appearance of possible red spots in the irradiated local area
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Men and women, 18 years old and older. Evidence of current venous or arterial thromboembolic disease diagnosed by standard of care clinical, radiographic, or laboratory testing or acute ischemic stroke. Informed consent provided by the subject. Exclusion Criteria Pulmonary embolus with a need for mechanical ventilation or other ventilator support (may be on oxygen delivered by nasal cannula or mask at an FiO2 of ≤ 0.40) Acute coronary syndrome (including unstable angina) Significant cardiac arrhythmia (may have atrial fibrillation controlled with medication) Intracardiac thrombus Any embolus or thrombus requiring vascular surgery or interventional radiology to attempt acute embolectomy or thrombectomy Sickle cell disease with vaso-occlusive crisis Sepsis or life-threatening infection Traumatic injury requiring hospitalization (within 30 days prior to enrollment) Pregnancy or breastfeeding Severe mental illness Other conditions deemed by the investigators to put the subject at greater risk
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sanjeeva Onteddu, MD
Phone
5016865135
Email
sronteddu@uams.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sanjeeva Onteddu, MD
Organizational Affiliation
University of Arkansas
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jonathan A Young
Organizational Affiliation
University of Arkansas
Official's Role
Study Director
Facility Information:
Facility Name
Univerisity of Arkansas for Medical Sciences
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sanjeeva Onteddu, M.D.
Phone
501-686-5135
Email
sronteddu@uams.edu

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
19411875
Citation
Dressler DK. Death by clot: acute coronary syndromes, ischemic stroke, pulmonary embolism, and disseminated intravascular coagulation. AACN Adv Crit Care. 2009 Apr-Jun;20(2):166-76. doi: 10.1097/NCI.0b013e3181a0b5e8.
Results Reference
background
PubMed Identifier
22903924
Citation
Nedosekin DA, Sarimollaoglu M, Galanzha EI, Sawant R, Torchilin VP, Verkhusha VV, Ma J, Frank MH, Biris AS, Zharov VP. Synergy of photoacoustic and fluorescence flow cytometry of circulating cells with negative and positive contrasts. J Biophotonics. 2013 May;6(5):425-34. doi: 10.1002/jbio.201200047. Epub 2012 Aug 20.
Results Reference
background
PubMed Identifier
30460154
Citation
Juratli MA, Menyaev YA, Sarimollaoglu M, Melerzanov AV, Nedosekin DA, Culp WC, Suen JY, Galanzha EI, Zharov VP. Noninvasive label-free detection of circulating white and red blood clots in deep vessels with a focused photoacoustic probe. Biomed Opt Express. 2018 Oct 23;9(11):5667-5677. doi: 10.1364/BOE.9.005667. eCollection 2018 Nov 1.
Results Reference
background
PubMed Identifier
17433897
Citation
Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007 Apr;44(2):62-9. doi: 10.1053/j.seminhematol.2007.02.004.
Results Reference
background
PubMed Identifier
16102026
Citation
Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost. 2005 Aug;3(8):1611-7. doi: 10.1111/j.1538-7836.2005.01415.x.
Results Reference
background
PubMed Identifier
2025141
Citation
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med. 1991 May;151(5):933-8.
Results Reference
background
PubMed Identifier
27227413
Citation
Juratli MA, Menyaev YA, Sarimollaoglu M, Siegel ER, Nedosekin DA, Suen JY, Melerzanov AV, Juratli TA, Galanzha EI, Zharov VP. Real-Time Label-Free Embolus Detection Using In Vivo Photoacoustic Flow Cytometry. PLoS One. 2016 May 26;11(5):e0156269. doi: 10.1371/journal.pone.0156269. eCollection 2016.
Results Reference
background
PubMed Identifier
21976458
Citation
Galanzha EI, Sarimollaoglu M, Nedosekin DA, Keyrouz SG, Mehta JL, Zharov VP. In vivo flow cytometry of circulating clots using negative photothermal and photoacoustic contrasts. Cytometry A. 2011 Oct;79(10):814-24. doi: 10.1002/cyto.a.21106. Epub 2011 Aug 16.
Results Reference
background
PubMed Identifier
22749928
Citation
Galanzha EI, Zharov VP. Photoacoustic flow cytometry. Methods. 2012 Jul;57(3):280-96. doi: 10.1016/j.ymeth.2012.06.009. Epub 2012 Jun 26.
Results Reference
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In Vivo Detection of Circulating Clots in Patients With Thromboembolism

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