Current research projects Prof. dr. M.V. Huisman and Dr. F.A. Klok

YEARS pregnancy study – Advanced diagnostic management of suspected PE in pregnant patients

Prospective multi-center management study of consecutive pregnant patients with suspected (recurrent) PE, who are evaluated with to the YEARS study algorithm, consisting of combo of three items of the Wells rule (clinical signs of DVT, hemoptysis, ‘PE most likely diagnosis’) and D-dimer test, with cut-off dependent on likelihood. In patients with high probability for PE, CTPA is performed. The goal of the study is to safely exclude PE in symptomatic pregnant patients with a reduction in the need for CTPA imaging.

HOME-PE study – randomised trial comparing two triaging rules in patients with PE

Several studies have demonstrated the possibility of outpatient management or early discharge for certain patients presenting acute pulmonary embolism (PE), but there is controversy on the optimal referral strategies and eligibility criteria for outpatient care. Patients with proven PE will be randomised to one of two triage rules, HESTIA and sPESI and those qualifying for home treatment, will be followed for safety – defined as recurrent VTE, bleeding and death, and efficiency – defined as the percentage of patients eligible for out of hospital treatment.

THEIA study – MRDTI in patients with suspected ipsilateral DVT

Multicentre study to evaluate the safety and efficacy of the diagnostic management of suspected recurrent ipsilateral deep vein thrombosis of the leg with MRDTI (Magnetic Resonance Direct Thrombus Imaging). MRDTI is a short MRI scan of 5 minutes without the need of contrast dye and can reliably distinguish chronic residual thrombotic scars from acute recurrent DVT. Diagnosis and treatment of patients with suspected recurrent ipsilateral DVT will be managed according to the MRDTI scan result.

Magnitude study – MRDTI in patients with suspected arm vein thrombosis

Multicentre study in the advanced diagnostic management of suspected arm vein thrombosis with MRDTI. MRDTI is tested versus repeat ultrasonography to establish the accuracy in the diagnosis of acute arm vein thrombosis.

InShape II study – structured follow-up algorithm after PE to detect CTEPH in early disease stages

Multicentre study to validate a newly developed follow-up algorithm in patients with acute PE aimed at early detection of CTEPH in a cost-effective manner. This algorithm consists of a clinical decision rule and in case of a non-low risk of CTEPH assessment of NT-proBNP and ECG reading. Only patients with abnormal EC or NT-proBNP will be referred for echocardiography. After a 2-year follow-up period, the occurrence of CTEPH in patients who were initially not referred for echocardiography will be evaluated.

PEITHO-2 study – treatment of patients with intermediate risk acute PE

Multicentre study to further define the treatment possibilities of patients with intermediate risk PE, i.e. PE with signs of right ventricular overload. All patients who meet the inclusion but none of the exclusion criteria will be treated with at least three days of low molecular weight heparin, followed by dabigatran. The recovery of cardiac function will be objectively assessed by sequential echocardiographies. Primary endpoint is recurrent symptomatic VTE or death related to PE within the first 6 months of anticoagulation treatment.

PRO-VALUE Registry

The PRO-VALUE registry aims to evaluate the clinical course and treatment with long-term low molecular weight heparin (LMWH) of oncology patients diagnosed in daily practice with venous thromboembolism (VTE). A prospective, cohort follow-up study, in cancer patients with established VTE, who are followed for six months is performed, to assess the rates of recurrent VTE, bleeding complications, mortality, treatment adherence, and to evaluate the impact of VTE on the quality of life of cancer patients