Lumbar Vein Embolization for Chronic Headaches with Nutcracker Physiology

Description

The purpose of this research is to gather information on the safety and feasibility of coiling the lumbar vein for the treatment of chronic headaches in patients with Nutcracker physiology and retrograde lumbar vein flow with epidural venous plexus congestion. All patients are extensively evaluated by a headache trained Neurologist confirming high pressure headache refractory to other treatments.

Conditions

Chronic Headache, Nutcracker Phenomenon, Renal, Nutcracker Syndrome, Renal

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Study Overview

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Study Details

Study overview

The purpose of this research is to gather information on the safety and feasibility of coiling the lumbar vein for the treatment of chronic headaches in patients with Nutcracker physiology and retrograde lumbar vein flow with epidural venous plexus congestion. All patients are extensively evaluated by a headache trained Neurologist confirming high pressure headache refractory to other treatments.

Lumbar Vein Embolization for the Treatment of Chronic Headache in Patients with Nutcracker Physiology and Retrograde Lumbar Vein Flow with Epidural Venous Plexus Enhancement

Lumbar Vein Embolization for Chronic Headaches with Nutcracker Physiology

Condition
Chronic Headache
Intervention / Treatment

-

Contacts and Locations

Jacksonville

Mayo Clinic Florida, Jacksonville, Florida, United States, 32224

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility 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.
  • * 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.

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Mayo Clinic,

Zlatko Devcic, MD, PRINCIPAL_INVESTIGATOR, Mayo Clinic

Study Record Dates

2027-09