Prospective Study on Embolization of Intracranial Aneurysms With Pipeline™ Embolization Device
- Conditions
- Intracranial Aneurysm
- Interventions
- Device: Pipeline™ Embolization Device/ Pipeline™Flex Embolization Device
- Registration Number
- NCT02186561
- Lead Sponsor
- Medtronic Neurovascular Clinical Affairs
- Brief Summary
The purpose of this study is to assess the safety and effectiveness of the Pipeline™ device in the treatment of unruptured, wide-neck intracranial aneurysms.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 197
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Subject has provided written informed consent using the IRB/EC-approved consent form and agrees to comply with protocol requirements.
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Age 22-80 years.
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Subject has a target intracranial aneurysm (IA) located in the:
- Internal carotid artery (up to the carotid terminus) OR
- Vertebral artery segment up to and including the posterior inferior cerebellar artery
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Subject has a target IA that is ≤ 12 mm.
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Subject has a target IA that has a parent vessel with diameter 1.5-5.0 mm distal/proximal to the target IA.
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Subject has a target IA with an aneurysm neck ≥ 4mm or a dome to neck ratio ≤ 1.5.
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Subject has a pre-procedure PRU value between 60-200.
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Subject has received an intracranial implant (e.g. coils) in the area of the target IA within the past 12 weeks.
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Subarachnoid hemorrhage in the past 30 days.
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Subject with anatomy not appropriate for endovascular treatment due to severe intracranial vessel tortuosity or stenosis determined from baseline or pre-procedure imaging, or a history of intracranial vasospasm not responsive to medical therapy.
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Major surgery in the last 30 days.
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History of irreversible bleeding disorder and/or subject presents with signs of active bleeding.
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Any known contraindication to treatment with the Pipeline™ device, including:
- Stent is in place in the parent artery at the target IA location
- Contraindication to dual antiplatelet therapy
- Relative contraindication to angiography (e.g., serum creatinine >2.5 mg/dL, allergy to contrast that cannot be medically controlled).
- Known severe allergy to platinum or cobalt/chromium alloys.
- Evidence of active infection at the time of treatment (e.g., fever with temperature >38°C and/or WBC >1.5 109/L).
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The Investigator determines that the health of the subject or the validity of the study outcomes (e.g., high risk of neurologic events, worsening of clinical condition in the last 30 days) may be compromised by the subject's enrollment.
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Pregnant or breast-feeding women or women who wish to become pregnant during the length of study participation.
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Participating in another clinical trial during the follow-up period that could confound the treatment or outcomes of this investigation.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Pipeline™ Embolization Device Pipeline™ Embolization Device/ Pipeline™Flex Embolization Device treatment with Pipeline™ Embolization Device
- Primary Outcome Measures
Name Time Method The Percentage of Participants With the Occurrence of Major Stroke in the Territory Supplied by the Treated Artery or Neurological Death at 12-Months Post Procedure Up to 12 Months Post Procedure The primary safety endpoint was defined as a stroke which results in focal neurological deficit for 24 hrs or more and increases the NIH Stroke Scale of the subject by ≥ 4 along with an imaging correlate. Missing data for subjects who failed to complete the 12- month post-procedure evaluation without any evidence of a major stroke in the territory supplied by the treated artery or neurological death were imputed in the analysis using multiple imputation. Multiple imputation provides a mechanism for deriving estimates for a population where not all of the patients have an endpoint determination.
The Percentage of Participants With Complete Aneurysm Occlusion (Defined as Raymond Roy Grade 1) Without Significant Parent Artery Stenosis (≤ 50%) or Retreatment of the Target Aneurysm at 12-Months Post-Procedure Up to 12 Months Post Procedure The definitions for the three components of the primary effectiveness endpoint were: 1) retreatment, defined as all retreatment procedures occurring between the index procedure and 1 Year post-procedure; 2) complete aneurysm occlusion based on Core Laboratory review of 1-year images and 3) significant parent artery stenosis, based on Core Laboratory review of 1-year images. The Raymond-Roy Grading scale is used for judging intracranial aneurysm (IA) endosaccular embolization success. Grade I is completion occlusion with no flow of contrast seen in the aneurysm sac, Grade II is partial occlusion with some flow or eddy flow in the aneurysm sac and Grade III is residual aneurysm or Incomplete occlusion with apparent flow in the aneurysm sac.
Multiple imputation provides a mechanism for deriving estimates for a population where not all of the patients have an endpoint determination.
- Secondary Outcome Measures
Name Time Method The Number of Participants Who Experienced Delayed Intracerebral Hemorrhage > 30 Days Post-Procedure > 30 days, Post Procedure For the purpose of this protocol, delayed intracerebral hemorrhage was defined as hemorrhage within the fixed vault of the cranium (skull) occurring greater than 30 days post-procedure.
The Number of Participants With a Major Stroke in the Territory Supplied by the Treated Artery or Neurological Death at 30-days Post Procedure Due to Procedural Complications Up to 30 days, Post Procedure Major Stroke is defined as a stroke which results in focal neurological deficit for 24 hrs or more and increases the NIH Stroke Scale of the subject by ≥ 4 along with an imaging correlate. Neurological death is any subject death due to neurologic reasons.
The Number of Participants With Successfully Deployed Investigational Device Index Procedure The secondary outcome measures provides the number of participants successfully implanted with the Investigational device during the study index procedure at the target site.
Trial Locations
- Locations (23)
Geisinger Medical Center
🇺🇸Danville, Pennsylvania, United States
St. Luke's Health Baylor College of Medicine
🇺🇸Houston, Texas, United States
Radiology Imaging Associates
🇺🇸Englewood, Colorado, United States
Tampa General Hospital
🇺🇸Tampa, Florida, United States
Baptist Medical Center Jacksonville
🇺🇸Jacksonville, Florida, United States
Florida Hospital
🇺🇸Winter Park, Florida, United States
The Emory Clinic
🇺🇸Atlanta, Georgia, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Baptist Physicians Lexington
🇺🇸Lexington, Kentucky, United States
University of Kentucky
🇺🇸Lexington, Kentucky, United States
The Johns Hopkins Hospital
🇺🇸Baltimore, Maryland, United States
Tufts University Medical Center
🇺🇸Boston, Massachusetts, United States
University of Massachusetts Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
Kaleida Health/University of Buffalo
🇺🇸Buffalo, New York, United States
Mayo Clinic Rochester
🇺🇸Rochester, Minnesota, United States
Stony Brook University
🇺🇸Stony Brook, New York, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Thomas Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
The Methodist Hospital
🇺🇸Houston, Texas, United States
University of Utah
🇺🇸Salt Lake City, Utah, United States
University of Wisconsin Hospital and Clinics
🇺🇸Madison, Wisconsin, United States
Toronto Western Hospital
🇨🇦Toronto, Ontario, Canada