Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID05679271

Intracranial Dural Arteriovenous Fistula Related Pulsatile Tinnitus Endovascular Treatment by Venous Stenting An Efficacy Study

Led by University Hospital, Bordeaux · Updated on 2025-02-11

48

Participants Needed

1

Research Sites

N/A

Total Duration

On this page

Sponsors

U

University Hospital, Bordeaux

Lead Sponsor

F

French Ministry of Social Affairs and Health

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating the effectiveness of venous stenting for treating dural arteriovenous fistulae (DAVF) that cause pulsatile tinnitus (PT). This trial compares venous stenting to no treatment in patients with low-grade DAVF, focusing on changes in Cognard's Classification at six months. The study aims to find a simpler, lower-risk option than existing treatments for patients with PT due to DAVF without neurological risk. Participants in the experimental group will receive venous stenting via a venous approach such as femoral, brachial, or jugular puncture. The stent is placed at the fistulous sinus, sometimes using multiple stents and balloon angioplasty. Antiaggregation medication with aspirin and clopidogrel or ticagrelor is given around the procedure. The control group will receive standard care with no treatment during the first six months, after which treatment may proceed as usual. Participants will be assessed at baseline and at 6, 12, and 24 months, including angiographic evaluation of DAVF, clinical scales like the THI score, modified Rankin Scale, and monitoring of symptoms such as concentration troubles, sleep problems, headaches, and dizziness. Safety is monitored through rates of stent thrombosis and deployment success. The total follow-up period extends up to 24 months to observe long-term outcomes.

CONDITIONS

Brief Title

Dural Sinus Stenting of Low Grade Dural Arteriovenous Fistulae (DAVF) for Pulsatile Tinnitus Treatment

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patient experiencing disabling pulsatile tinnitus
  • Pulsatile tinnitus anatomically linked to a dural arteriovenous fistula (DAVF)
  • DAVF classified as Type I or IIa by Cognard's classification via digital subtraction angiography
  • DAVF located on the sigmoid, lateral, or posterior longitudinal sinus
  • Fistula length suitable for use of up to two stents
  • Women of childbearing potential must use highly effective contraception during study procedures
  • Affiliated with or beneficiary of health insurance
  • Signed informed consent provided
Not Eligible

You will not qualify if you...

  • DAVF not eligible for endovascular treatment
  • DAVF classified as IIb or higher according to Cognard's classification
  • Severe sinus stenosis or occlusion preventing sinus stenting
  • Recent thrombophlebitis at fistulous dural sinus site within last 3 months
  • Previous surgery or radiotherapy for DAVF
  • Multiple DAVF present
  • Contralateral sinus aplasia or occlusion
  • Contraindication to liquid embolic agent use
  • Participation in another medical device clinical study
  • Conditions preventing attendance at 6-month follow-up
  • Known allergy to heparin, aspirin, Coumadin, Warfarin, or other antiplatelet drugs
  • Surgery including endovascular procedures within 30 days prior
  • Intracranial or subarachnoid hemorrhage within 30 days prior
  • Sensitivity to radiographic contrast agents
  • Sensitivity to nickel, titanium, or their alloys
  • Renal failure with serum creatinine above 2.5 mg/dl or GFR below 30
  • Contraindication to MRI or angiography
  • Pregnant, lactating, or planning pregnancy during study
  • Unable or unwilling to provide informed consent
  • Under legal protection or guardianship

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Implementation

Duration - 1 day

Participants assigned to venous stenting undergo the stenting procedure involving the placement of one or two stents in the fistulous sinus, accompanied by an antiaggregation protocol.

1 visit (in-person)

Monitoring

Duration - Up to 24 months

Participants in the no treatment group are observed without active intervention to assess the natural progression of their condition.

Visits at baseline, Month 6, Month 12, and Month 24

Follow-up

Duration - Up to 24 months

All participants are followed up to evaluate treatment efficacy, safety, and symptom changes including pulsatile tinnitus and neurological assessments.

Visits at Month 6, Month 12, and Month 24

Trial Site Locations

Total: 1 location

1

CHU Bordeaux

Bordeaux, France

Actively Recruiting

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Research Team

X

Xavier BARREAU, MD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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