Deep Vein Thrombosis

Clinical Trial Examines tPA as Potential DVT Treatment

A new National Heart, Lung, and Blood Institute-funded trial at the University of Virginia Health System will examine the effectiveness of tissue plasminogen activator (tPA) as a potential treatment for lower-extremity deep vein thrombosis (DVT).

The standard treatment for DVT is anti-coagulation therapy, says interventional radiologist John Fritz Angle, MD, the study’s principal investigator at UVA. Anti-coagulation therapy helps prevent the progression of DVT and the incidence of pulmonary embolism, but may not prevent long-term damage to leg veins from clots that are already present, he says.

Those clots can damage vein valves and cause occlusions that lead to chronic venous disease, Angle says. Chronic venous disease, in turn, can cause chronic leg swelling, hyperpigmented skin and even ulcers in some cases.

The ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis) trial is designed to find out whether infusing tPA into the clot through a catheter placed in the clot with ultrasound and fluoroscopic guidance can dissolve most or all of the blood clot in the leg vein, help regain function in the leg vein, avoid chronic venous disease and improve quality of life. Patients will receive a maximum of 24 hours of catheter-delivered tPA and receive two years of follow-up evaluation by hematologists and co-investigator B. Gail Macik, MD. Nearly 700 patients will be randomized nationally in this study to receive either anti-coagulation therapy only or anti-coagulation therapy together with the catheter-infused tPA.

The main inclusion criteria for the trial are otherwise healthy patients suffering their first deep vein thrombosis in their femoral, common femoral or iliac veins.

To refer a patient to the ATTRACT trial, call UVA Physician Direct at 800.552.3723.

Which Patients May Be Candidates for the ATTRACT Trial?

Inclusion Criteria

  • Symptomatic, lower-extremity DVT in the iliac, common femoral or femoral veins

Exclusion Criteria

  • Patients with subacute or chronic DVT
  • History of stroke, intracranial or intraspinal bleeding, tumor, vascular malformation, aneurysms, severe hypertension or recent surgery
  • Hypercoagulable disorders, including known malignancy