Actively Recruiting

Phase 4
Age: 18Years +
All Genders
NCT04263038

Clinical Surveillance vs. Anticoagulation for Low-risk Patients With Isolated Subsegmental Pulmonary Embolism

Led by Drahomir Aujesky · Updated on 2025-05-30

276

Participants Needed

39

Research Sites

311 weeks

Total Duration

On this page

Sponsors

D

Drahomir Aujesky

Lead Sponsor

U

University of Bern

Collaborating Sponsor

AI-Summary

What this Trial Is About

The clinical significance of pulmonary embolism (PE) limited to the subsegmental pulmonary arteries, so called isolated subsegmental pulmonary embolism (SSPE), remains controversial. Whether isolated SSPE represents "true" PE, a clinically more benign form of PE, a physiologic lung clearing process, or a false positive result (artifact) is currently unclear and hence, whether patients with isolated SSPE benefit from anticoagulant treatment is uncertain. Despite growing evidence from observational studies that withholding anticoagulation may be a safe option in selected patients with isolated SSPE (i.e., those without concomitant deep vein thrombosis, cancer, etc.), most patients with isolated SSPE receive anticoagulant treatment, which is associated with an increased risk of bleeding. The overall objective of the randomized controlled SAFE-SSPE trial is to evaluate the efficacy and safety of clinical surveillance without anticoagulation compared to anticoagulation treatment in low-risk patients with isolated SSPE.

CONDITIONS

Official Title

Clinical Surveillance vs. Anticoagulation for Low-risk Patients With Isolated Subsegmental Pulmonary Embolism

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Signed informed consent form
  • Age 18 years or older
  • Confirmed diagnosis of symptomatic or asymptomatic isolated subsegmental pulmonary embolism (SSPE)
Not Eligible

You will not qualify if you...

  • Presence of leg or upper extremity deep vein thrombosis (DVT)
  • Active cancer treated within the last 6 months
  • One or more prior episodes of unprovoked venous thromboembolism (VTE)
  • Clinical instability with low blood pressure or low oxygen saturation at presentation
  • Active bleeding or high risk of bleeding
  • Severe kidney failure with creatinine clearance less than 30 ml/min
  • Severe liver failure (Child-Pugh class B or C)
  • Use of strong CYP3A4 inhibitors or inducers
  • Known allergy to rivaroxaban
  • Need for anticoagulation for reasons other than SSPE
  • Anticoagulation treatment for more than 72 hours before screening
  • Hospitalization longer than 72 hours before SSPE diagnosis
  • Known pregnancy or breastfeeding without safe contraception
  • Refusal or inability to give informed consent
  • Prior participation in this trial

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 39 locations

1

Centre hospitalier universitaire de Liege

Liège, Belgium

Not Yet Recruiting

2

Cliniques Universitaires Saint-Luc

Woluwe-Saint-Lambert, Belgium

Actively Recruiting

3

The Ottawa Hospital

Ottawa, Canada

Actively Recruiting

4

Hôpital Bicêtre - APHP

Le Kremlin-Bicêtre, Le Kremlin-Bicêtre, France, 94270

Actively Recruiting

5

Centre Hospitalier Regional Et Universitaire De Brest

Brest, France

Actively Recruiting

6

CHU Gabriel-Montpied

Clermont-Ferrand, France

Actively Recruiting

7

Centre Hospitalier Universitaire De Dijon

Dijon, France

Actively Recruiting

8

Hospital Edouard Herriot

Lyon, France

Actively Recruiting

9

CHU De Rouen

Rouen, France

Actively Recruiting

10

CHU ST Etienne - Hôpital Nord

Saint-Priest-en-Jarez, France

Actively Recruiting

11

Albert Schweitzer Ziekenhuis Dordrecht

Dordrecht, Netherlands

Actively Recruiting

12

Medisch Spectrum Twente

Enschede, Netherlands

Actively Recruiting

13

Leiden University Medical Center

Leiden, Netherlands

Actively Recruiting

14

Erasmus Universitair Medisch Centrum

Rotterdam, Netherlands

Actively Recruiting

15

Haaglanden Medisch Centrum

The Hague, Netherlands

Withdrawn

16

Isala Klinieken Zwolle

Zwolle, Netherlands

Actively Recruiting

17

Cantonal Hospital of Liestal

Liestal, Basel, Switzerland

Actively Recruiting

18

Cantonal Hospital of Aarau

Aarau, Canton of Aargau, Switzerland

Actively Recruiting

19

University Hospital Inselspital

Bern, Canton of Bern, Switzerland, 3010

Actively Recruiting

20

Hospital of Bienne

Biel/Bienne, Canton of Bern, Switzerland

Actively Recruiting

21

Cantonal Hospital of Fribourg

Fribourg, Canton of Fribourg, Switzerland

Actively Recruiting

22

Cantonal Hospital of Lucerne

Lucerne, Canton of Lucerne, Switzerland

Withdrawn

23

Cantonal Hospital of Olten

Olten, Canton of Solothurn, Switzerland

Withdrawn

24

Cantonal Hospital of St. Gallen

Sankt Gallen, Canton of St. Gallen, Switzerland

Actively Recruiting

25

University Hospital of Lausanne

Lausanne, Canton of Vaud, Switzerland

Actively Recruiting

26

Hospital of Nyon

Nyon, Canton of Vaud, Switzerland

Withdrawn

27

Cantonal Hospital of Winterthur

Winterthur, Canton of Zurich, Switzerland

Actively Recruiting

28

Triemli Hospital

Zurich, Canton of Zurich, Switzerland

Actively Recruiting

29

University Hospital Zürich

Zurich, Canton of Zurich, Switzerland

Actively Recruiting

30

Cantonal Hospital of Frauenfeld

Frauenfeld, Thurgau, Switzerland

Actively Recruiting

31

Hospital of Sion

Sion, Valais, Switzerland

Withdrawn

32

Cantonal Hospital of Uri

Altdorf, Switzerland

Withdrawn

33

Cantonal Hospital of Baden

Baden, Switzerland

Actively Recruiting

34

University Hospital of Basel

Basel, Switzerland

Actively Recruiting

35

Tiefenau Hospital

Bern, Switzerland

Completed

36

Regional Hospital of Emmental

Burgdorf, Switzerland

Actively Recruiting

37

Hospital of Delémont

Delémont, Switzerland

Actively Recruiting

38

Geneva University Hospital

Geneva, Switzerland

Actively Recruiting

39

Hospital of Neuchâtel

Neuchâtel, Switzerland

Actively Recruiting

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Research Team

D

Drahomir Aujesky, Prof. MD MSc

CONTACT

T

Tobias Tritschler, Dr. MD MSc

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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