Effectiveness of Coiling the Lumbar Vein for the Treatment of Chronic Headache in the Setting of Nutcracker Physiology With Retrograde Lumbar Vein Flow

Overview

About this study

The purpose of this study is to determine the effectiveness of coiling the lumbar vein for the treatment of chronic headache in the setting of Nutcracker physiology with retrograde lumbar vein flow and early epidural venous plexus enhancement.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

* Daily headache from onset lasting \> 3 months.
* Headache described as pressure sensation.
* Headache worsened in the Trendelenburg position.
* Exposed to CSF pressure/volume lowering medications.
* Tried 2 of 4 unless contraindications: acetazolamide, methazolamide, indomethacin SR or spironolactone) or CSF volume removal via LP with positive or neutral response.
* Failed at least 3 typical headache preventative medications from different classes-antidepressants, antiepileptic, blood pressure medications.
* MRI demonstrates that Nutcracker physiology is present.
* Decreased SMA angle, renal vein narrowing, decreased AMD.
* Retrograde lumbar vein flow and early EVP enhancement.
* Ability to understand study procedures and to comply with them for the entire length of the study.
* Negative pregnancy test.

Exclusion Criteria:

* Evidence of disc edema.
* Positive urinalysis for hematuria or proteinuria.
* Abnormal CBC or CMP.
* MRI, MRA head and neck and MR venogram with a possible secondary causes of headache including space occupying lesions, Chiari malformation, cerebral vein thrombosis, hydrocephalus, dissection, aneurysm etc.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 7/17/2024. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Zlatko Devcic, M.D.

Open for enrollment

Contact information:

Zlatko Devcic M.D.

(904) 953-1496

Devcic.Zlatko@mayo.edu

More information

Publications

Publications are currently not available
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CLS-20555122

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