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Evaluating the Safety and Efficacy of the Maurora® DES in ICAS

Not Applicable
Active, not recruiting
Conditions
Stroke (CVA) or TIA
Intracranial Arteriosclerosis
Interventions
Device: APOLLO™ Intracranial Stent System
Device: Maurora® Sirolimus Eluting Stent System
Registration Number
NCT05719883
Lead Sponsor
Beijing Tiantan Hospital
Brief Summary

The purpose of the RCT trial is to evaluate whether implantation of drug-eluting stent (DES) is more efficacious than bare metal stent (BMS) in prevention of in-stent restenosis (ISR) and improvement of outcomes for symptomatic intracranial atherosclerotic stenosis. This trial is prospective, multi-center, randomized 1:1 single blind trial using Maurora sirolimus eluting stent versus Apollo bare metal stent conducted in approximately 10 interventional neurology centers in China. The study is sponsored by Alain Medical (Beijing) Co., Ltd.

Detailed Description

This trial is a prospective, multi-center, 1:1 randomized using drug-eluting (Sirolimus) stent versus bare metal stent (BMS) to treat intracranial stenosis of 70-99% degree. The primary endpoint is in-stent restenosis rate(ISR) within 12 months after revascularization procedure of the qualifying lesion during follow-up.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
156
Inclusion Criteria
  1. Age from 18 to 85 years;
  2. Symptomatic intracranial atherosclerosis (Definition: Stroke or transient ischemic attack [TIA] associated with intracranial atherosclerosis within 90 days of enrollment);
  3. A major intracranial artery (carotid artery, MCA stem [M1], vertebral artery, or basilar artery) with 70% to 99% stenosis on the angiography (According to WASID method);
  4. The target lesion length ≤15 mm and the vessel diameter between 2.5mm and 5.0mm, distal vessel diameter >1.5mm;
  5. Only one stent planned for the target lesion;
  6. A Modified Rankin Score of ≤ 3;
  7. Patients understand the purpose and requirements of the study, and can make him/herself understood, and has provided informed consent.
Exclusion Criteria
  1. Ischemic stroke within 2 weeks before the procedure;
  2. Tandem extracranial or intracranial stenosis (70%-99%) of the target lesion;
  3. Patients with stroke caused by perforating artery occlusion;
  4. Severe calcification at target lesion;
  5. Any history of brain parenchymal or other intracranial subarachnoid, subdural or extradural hemorrhage in the past 6 weeks;
  6. History of stenting or angioplasty of an intracranial artery;
  7. Intracranial tumor, aneurysm or intracranial arteriovenous malformation;
  8. Intracranial artery stenosis caused by non-atherosclerotic lesions, including: moya-moya disease, vasculitis disease, herpes zoster, varicella-zoster or other viral vascular diseases, neurosyphilis, any other intracranial infections, radiation-induced vascular disease, fibromuscular dysplasia, sickle cell disease, neurofibromatosis, central nervous system benign vascular disease, post-partum vascular disease, suspected vasospasm, suspicious embolism recanalization;
  9. Presence of any unequivocal cardiac source of embolism (e.g. atrial fibrillation);
  10. Those who cannot tolerate general anesthesia due to insufficiency of cardiac or pulmonary function, not suitable for procedure;
  11. Known allergy or contraindication to heparin, aspirin, ticlopidine, ticagrelor, sirolimus, anaesthetics and contrast agents;
  12. Severe renal and hepatic insufficiency (ALTor AST > 3x upper limit, creatinine > 1.5x upper limit);
  13. Major surgery within the past 30 days or planned within 90 days, or requiring simultaneous intervention to renal artery, iliac artery, and coronary artery;
  14. Life expectancy <12 months;
  15. Pregnant or lactating women, or planning for pregnancy;
  16. Participated in another investigational device or drug study within 30 days;
  17. According to the judgement of the investigator, other situations that are not suitable for enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
APOLLO™ Intracranial Stent SystemAPOLLO™ Intracranial Stent SystemDevice: Apollo Intracranial Stent System A 316L stainless steel balloon-expandable intracranial stent system.
Maurora® Sirolimus Eluting Stent SystemMaurora® Sirolimus Eluting Stent SystemDevice: Maurora® Sirolimus Eluting Stent System A sirolimus eluting intracranial stent system with platform is made of L605 CoCr alloys.
Primary Outcome Measures
NameTimeMethod
In-stent restenosis rate(ISR) within 12 months after procedure12 months after procedure

Angiographic evidence of in-stent stenosis ≥50% at 12 months after procedure

Secondary Outcome Measures
NameTimeMethod
Implantation success rateDuring the procedure

Implantation success was defined as successful arrival of stent to the lesion and subsequent release of the stent delivery system.

Ischemic stroke in other vessel territory between 31 day to 1 year after procedurebetween 31 day to 1 year after procedure

Any ischemic stroke events unrelated to target vessel after revascularization.Ischemic stroke is defined as a new focal neurological deficit of sudden onset, that is associated with infarction lesion on CT or MRI. Ischemic strokes are classified as in or out of the territory of the symptomatic intracranial artery.

Any ischemic stroke between 31 day to 1 year after procedurebetween 31 day to 1 year after procedure

Ischemic stroke is defined as a new focal neurological deficit of sudden onset, that is associated with infarction lesion on CT or MRI. Ischemic strokes are classified as in or out of the territory of the symptomatic intracranial artery.

Ischemic stroke in the target vessel territory between 31 day to 1 year after procedurebetween 31 day to 1 year after procedure

Any ischemic stroke events related to target vessel after revascularization.

Death between 31 day to 1 year after procedurebetween 31 day to 1 year after procedure

All-cause death.

Functional outcome measured by the modified Rankin Scale1 and 12 months after procedure

Focus on difference between 1 month and 12 months after procedure. The range of modified Rankin Scale was from 0 to 6. 0-No symptoms; 1-No significant disability; 2-Slight disability; 3-Moderate disability; 4-Moderately severe disability; 5-Severe disability; 6 -Dead. A higher score indicates worse a outcome.

Technical success rateDuring the procedure

Technical success was defined as successful arrival of stent to the lesion and subsequent release of the stent delivery system with a residual stenosis of \<30%.

Stroke in the target vessel territory or death within 30 days after procedurewithin 30 days after procedure

Death or any stroke events related to target vessel after revascularization.

Any subdural, epidural hemorrhage or a systemic hemorrhage between 31 day to 1 year after procedurebetween 31 day to 1 year after procedure

Any subdural or epidural hemorrhage or a systemic hemorrhage is required hospitalization, blood transfusion, or surgery.

Clinical success rate12 months after procedure

Clinical success was defined as successful arrival of stent to the lesion and subsequent release of the stent delivery system with a residual stenosis of \<30%, and free from major adverse event within 12 months after procedure.

system with a residual stenosis of \<30%

Stroke or death within 30 days after procedurewithin 30 days after procedure

Any stroke included ischemic stroke or/and symptomatic brain hemorrhage and all-cause death.

Transient Ischemic Attack within 1 year after the procedure1 year after the procedure

A transient ischemic attack (TIA) is a temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes up to 24 hours and doesn't cause permanent damage.

Trial Locations

Locations (1)

Beijing Tiantan Hospital

🇨🇳

Beijing, Beijing, China

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