Evaluation of Safety and Effectiveness of Stryker Surpass Evolve™ Flow Diverter System
- Conditions
- Aneurysm, Intracranial
- Interventions
- Device: Surpass Evolve Flow Diverter System
- Registration Number
- NCT04195568
- Lead Sponsor
- Stryker Neurovascular
- Brief Summary
The primary objective of this study is to evaluate the safety and effectiveness of the Surpass™ Evolve Flow Diverter System in the treatment of unruptured, wide-neck intracranial aneurysms measuring ≤ 12 mm and located on the ICA or its branches
- Detailed Description
The Surpass Evolve Flow Diverter System is indicated for the endovascular treatment of adults (age 18 or above) with unruptured saccular wide-neck or fusiform intracranial aneurysms ≤ 12 mm for treatment in vessel diameters between 1.75-5.0mm.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 248
-
Age is ≥ 18 and ≤ 80 years
-
Has a single unruptured target intracranial aneurysm (IA) with the following characteristics:
- Is located on the internal carotid artery (ICA) or its branches.
- Has a neck ≥ 4 mm, dome to neck ratio ≤ 2.0, or no discernible neck
- Aneurysm size is ≤ 12 mm (saccular or fusiform configuration)
-
Has a parent vessel diameter ≥ 1.75 mm and ≤ 5.0 mm at both the proximal and distal segments where the implant will be placed
-
Has multiple increased risk factors for intracranial (IA) aneurysm rupture, including but not limited to, aneurysm morphology, smoking, hypertension, diabetes, age, prior and/or family history of rupture, and/or history of subarachnoid hemorrhage that may result in a benefit risk profile of endovascular treatment that outweighs the risks of intracranial aneurysm rupture during the subject's expected lifetime if left untreated.
- Has an extradural target aneurysm
- Has a target aneurysm in the posterior circulation
- Perforator or branch vessel, inclusive of the posterior communicating artery, arises from the target aneurysm body or neck (branches or arteries must arise or connect from the parent vessel separate from the aneurysm or neck to not be excluded from study)
- Has a true bifurcation aneurysm, defined as an aneurysm (saccular or non-saccular) located at a point of vessel bifurcation
- Target aneurysm is unsuitable for flow diverter treatment
- Has vessel characteristics, such as severe tortuosity (cICA Type IV), stenosis (>70%), or morphology that would preclude safe endovascular access to the target aneurysm necessary for treatment with the study device
- Received previous treatment of the target aneurysm or parent artery where it would interfere with the placement or proper apposition of the device
- Has a medical contraindication to study or procedure related antiplatelet medications (aspirin, clopidogrel/Plavix, ticagrelor, and heparin), local or general anesthesia, or life-threatening allergy to contrast dye
- Has a known severe allergy to nickel, chromium cobalt, tungsten or platinum.
- Modified Rankin Score (mRS) assessment is ≥ 3 at preprocedure exam
- Presence of unstable neurological deficit (i.e., worsening of clinical condition in the last 30 days)
- Subarachnoid hemorrhage occurred within 30 days prior to enrollment
- Major surgery (including previous intracranial implant) occurred within previous 30 days or is planned in the next 120 days after enrollment date
- Has more than one IA that requires treatment within 12 months
- Received previous intracranial implant associated with the symptomatic or vascular distribution within the past 12 weeks prior to treatment date
- Chronic anticoagulation therapy is ongoing or known coagulopathy exists
- Has other known serious concurrent medical conditions such as heart disease (e.g., unstable atrial fibrillation [with or without pacemaker], recent myocardial infarction [< 12 weeks ago], symptomatic congestive heart failure, or carotid stenosis), kidney failure [>2.0mg/dl serum creatinine], pulmonary disease, uncontrolled diabetes, progressive neurologic disorders, terminal cancer, vasculitis, high risk of ischemic stroke or recent stroke
- Has acute life-threatening illness other than the neurological disease (e.g., acute kidney or heart failure) to be treated in this trial
- Life expectancy is less than 5 years due to other illness or condition (in addition to an intracranial aneurysm)
- Unable to complete study follow up due to dementia or psychiatric problem, substance abuse, or history of noncompliance with medical advice
- Pregnancy at time of enrollment
- Presence of intracranial mass (tumor, except meningioma, abscess, or other infection), non-treated arteriovenous malformation (AVM) in the territory of the target aneurysm
- Evidence of active infection at the time of treatment
- Enrollment in another trial involving an investigational product that could confound the outcomes of this trial
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Surpass Evolve Flow Diverter System Surpass Evolve Flow Diverter System This is a prospective single arm study in which all subjects who present for flow diverter implantation, provide informed consent, and meet inclusion/exclusion criteria may receive treatment (Surpass Evolve Flow Diverter).
- Primary Outcome Measures
Name Time Method Primary Effectiveness Endpoint 12 months (± 3 months) post procedure The primary effectiveness endpoint of this study is a composite of 100% occlusion (Raymond 1, complete occlusion) of the target aneurysm without significant parent artery stenosis (\>50% stenosis), per independent core lab assessment of digital subtraction angiography (DSA) images acquired at 12 months (± 3 months) post-procedure, and with no target aneurysm retreatment.
Primary Safety Endpoint 12 Months (± 3 months) post procedure The primary safety endpoint of this study is neurologic death, or disabling stroke at 12 months as adjudicated by an independent Clinical Events Committee (CEC).
- Secondary Outcome Measures
Name Time Method Secondary Safety Endpoints 3 Year Follow-Up The secondary safety endpoints will be evaluated throughout the study, and are as follows:
1. Neurological death or major ipsilateral stroke as adjudicated by an independent Clinical Events Committee.
2. Stroke in the treated vascular territory as adjudicated by a Clinical Events Committee
Trial Locations
- Locations (37)
Montefiore Medical Center
🇺🇸Bronx, New York, United States
DIGNITY HEALTH/ Barrow Neurological Institute
🇺🇸Phoenix, Arizona, United States
St. Joseph's Hospital
🇺🇸Tucson, Arizona, United States
University of California, Los Angeles
🇺🇸Los Angeles, California, United States
Lyerly Baptist, Inc./Baptist Medical Center - Jacksonville/Lyerly Neurosurgery
🇺🇸Jacksonville, Florida, United States
Baptist Hospital of Miami
🇺🇸Miami, Florida, United States
Mayo Clinic Florida
🇺🇸Jacksonville, Florida, United States
Tallahassee Neurological Clinic
🇺🇸Tallahassee, Florida, United States
Advocate Lutheran General Hospital
🇺🇸Park Ridge, Illinois, United States
Indiana University
🇺🇸Indianapolis, Indiana, United States
University of Iowa
🇺🇸Iowa City, Iowa, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Baptist Healthcare System, Inc./Baptist Health
🇺🇸Lexington, Kentucky, United States
Maine Medical Center
🇺🇸Portland, Maine, United States
Tufts Medical Center
🇺🇸Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Lahey Clinic
🇺🇸Burlington, Massachusetts, United States
University of Massachusetts
🇺🇸North Worcester, Massachusetts, United States
Spectrum Health
🇺🇸Grand Rapids, Michigan, United States
Robert Wood Johnson University Medical Center
🇺🇸New Brunswick, New Jersey, United States
University of Buffalo
🇺🇸Buffalo, New York, United States
ICAHN School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
Stony Brook
🇺🇸Stony Brook, New York, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
Oregon Health & Science University
🇺🇸Portland, Oregon, United States
Thomas Jefferson University
🇺🇸Philadelphia, Pennsylvania, United States
Geisinger Clinic
🇺🇸Wilkes-Barre, Pennsylvania, United States
Semmes Murphey Clinic/ University of Tennessee Health Sciences Center
🇺🇸Memphis, Tennessee, United States
University of Texas Medical Branch
🇺🇸Galveston, Texas, United States
Valley Baptist Health System, Harlingen
🇺🇸Harlingen, Texas, United States
University of Utah
🇺🇸Salt Lake City, Utah, United States
Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States
Liverpool Hospital
🇦🇺Liverpool, New South Wales, Australia
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Perth, Australia
Gold Coast Hospital & Health Service/ Gold Coast University Hospital
🇦🇺Southport, Queensland, Australia
St. Michael's Hospital - Toronto
🇨🇦Toronto, Ontario, Canada
University Health Network/ Toronto Western Hospital
🇨🇦Toronto, Ontario, Canada