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A Randomized, Controlled Trial to Evaluate the Safety and Effectiveness of the Route 92 Medical Reperfusion System (SUMMIT MAX)

Not Applicable
Completed
Conditions
Acute Ischemic Stroke
Interventions
Device: Route 92 Medical Reperfusion System
Registration Number
NCT05018650
Lead Sponsor
Route 92 Medical, Inc.
Brief Summary

The SUMMIT MAX study is a prospective, randomized, controlled, interventional clinical trial to evaluate the safety and effectiveness of the Route 92 Medical MonoPoint® Reperfusion System with the Hi Point 88 and HiPoint 70 Reperfusion Catheters for aspiration thrombectomy in acute ischemic stroke patients.

Detailed Description

The purpose of the SUMMIT MAX study is to obtain the safety and effectiveness data necessary to demonstrate substantial equivalence of the Route 92 Medical Reperfusion System with a predicate aspiration device to support a 510(k) application to the U.S. Food and Drug Administration (FDA) under the classification product code, NRY.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
250
Inclusion Criteria
  1. The consent process has been completed and documented according to applicable country regulations and as approved by the IRB / Ethics Committee
  2. Age >=18 years
  3. Patient presenting with clinical signs consistent with an acute ischemic stroke
  4. Baseline National Institutes of Health Stroke Scale (NIHSS) score >= 6
  5. Pre-stroke modified Rankin Score (mRS) <= 2
  6. Baseline ASPECTS >= 6
  7. Endovascular treatment initiated (defined as time of groin puncture) within 8 hours from time last known well
  8. If indicated, thrombolytic therapy shall be initiated per clinical guidelines. If eligible for thrombolytic therapy, subjects should be treated as soon as possible and lytic use should not be delayed regardless of potential eligibility for mechanical neurothrombectomy.
  9. The patient is indicated for aspiration neurothrombectomy with the Route 92 Medical Reperfusion System as determined by the Investigator
  10. Angiographic confirmation of a large vessel occlusion of the M1 segment of the middle cerebral artery or distal internal carotid artery
Exclusion Criteria
  1. Known pregnancy or breast feeding
  2. In the Investigator's opinion, any known comorbidity (including COVID-19 positivity) that may complicate treatment or prevent improvement or follow-up
  3. Known serious, advanced, or terminal illness with anticipated life expectancy < 12 months
  4. Known history of severe allergy to contrast medium
  5. Known to have suffered a stroke in the past 90 days
  6. Known connective tissue disorder affecting the arteries (e.g. Marfan syndrome, Ehlers-Danlos syndrome)
  7. Any known previous cerebral hemorrhagic event
  8. Any known pre-existing coagulation deficiency
  9. Known hemorrhagic diathesis, coagulation factor deficiency, or oral anticoagulant therapy with INR >3.0
  10. Known baseline platelet count <50,000/µL
  11. Known baseline blood glucose of <50 mg/dL or >400 mg/dL
  12. Known to be participating in another study involving an investigational device or drug
  13. Clinical symptoms suggestive of bilateral stroke or stroke in multiple territories.
  14. Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) evidence of recent/ fresh cerebral hemorrhage (the presence of microbleeds is allowed)
  15. Baseline CT or MRI showing intracranial tumor (except small meningioma <= 2cm) or significant mass effect with midline shift due to the tumor
  16. Presumed septic thrombus, or suspicion of bacterial endocarditis
  17. Inability to access the cerebral vasculature in the opinion of the neurointerventional team
  18. Unlikely to be available for a 90-day follow-up (e.g. no fixed home address)
  19. Evidence of arterial dissection in a vessel that must be traversed
  20. Evidence of high-grade stenosis or occlusion (i.e., tandem occlusion) in a vessel that must be traversed
  21. Known active or recent history of cocaine or methamphetamine abuse (within last 6 months)
  22. Known history or presence of aneurysm or arteriovenous malformation (AVM) in the territory of the target lesion
  23. For all patients, severe sustained hypertension with SBP >200 and/or DBP >120; for patients treated with a lytic, sustained hypertension despite treatment with SBP >185 and/or DBP >110
  24. Treatment with heparin within 48 hours with a partial thromboplastic time more than two times the laboratory normal or treatment with any LMWH within 48 hours
  25. Renal failure with serum creatinine >3.0 or Glomerular Filtration Rate (GFR) <30
  26. Ongoing seizure due to stroke
  27. Evidence of active systemic infection
  28. Known cancer with metastases
  29. Angiographic evidence of a dissection in the extracranial or intracranial cerebral arteries
  30. Arterial stenosis requiring balloon angioplasty or stenting at the time of the procedure
  31. Angiographic evidence of multiple cerebrovascular occlusions (e.g., bilateral anterior circulation, anterior/posterior circulation, tandem occlusions)
  32. Angiographic evidence of known or suspected underlying intracranial vasculopathy or atherosclerotic lesions responsible for the target occlusion
  33. Angiographic evidence or suspicion of aortic dissection
  34. Angiographic evidence of an aneurysm or arteriovenous malformation (AVM) in the territory of the target lesion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Aspiration PredicateRoute 92 Medical Reperfusion SystemAspiration thrombectomy with a predicate aspiration device to treat acute ischemic stroke
Route 92 Medical Monopoint Reperfusion SystemRoute 92 Medical Reperfusion SystemAspiration thrombectomy with the Route 92 Medical HiPoint 88 and HiPoint 70 Reperfusion Catheters as part of the Monopoint Reperfusion System to treat acute ischemic stroke
Primary Outcome Measures
NameTimeMethod
Proportion of subjects with successful arterial revascularization defined as a modified Thrombolysis in Cerebrovascular Infarction (mTICI) score of 2b or greaterDuring procedure

mTICI of 2b or greater indicates successful reperfusion following blood clot removal

Incidence of all symptomatic intracerebral hemorrhage (sICH)within 24 hours post-procedure

Evaluation of sICH per von Kummer et al

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (30)

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Baptist Hospital of Miami

🇺🇸

Miami, Florida, United States

Mercy San Juan Medical Center

🇺🇸

Carmichael, California, United States

Tufts

🇺🇸

Boston, Massachusetts, United States

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

University of Massachusetts

🇺🇸

Worcester, Massachusetts, United States

Advocate Aurora Health

🇺🇸

Chicago, Illinois, United States

Baptist Health Lexington

🇺🇸

Lexington, Kentucky, United States

Ohio Health

🇺🇸

Columbus, Ohio, United States

West Virginia University

🇺🇸

Morgantown, West Virginia, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

Medical City Plano

🇺🇸

Plano, Texas, United States

Valley Baptist

🇺🇸

Harlingen, Texas, United States

Auckland City Hospital

🇳🇿

Auckland, New Zealand

Stony Brook University Hospital

🇺🇸

Stony Brook, New York, United States

Geisinger Clinic

🇺🇸

Danville, Pennsylvania, United States

University of Kansas

🇺🇸

Kansas City, Kansas, United States

Baptist Jacksonville

🇺🇸

Jacksonville, Florida, United States

Mercy Health St. Vincent

🇺🇸

Toledo, Ohio, United States

Wright State University

🇺🇸

Dayton, Ohio, United States

Christiana Care

🇺🇸

Newark, Delaware, United States

Banner Health

🇺🇸

Mesa, Arizona, United States

Fort Sanders Medical Center

🇺🇸

Knoxville, Tennessee, United States

Cooper Health System

🇺🇸

Camden, New Jersey, United States

Rutgers

🇺🇸

Piscataway, New Jersey, United States

Saint Luke's

🇺🇸

Kansas City, Missouri, United States

OHSU

🇺🇸

Portland, Oregon, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

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