Neuroform Atlas Stent System Study (ATLAS)
Primary Purpose
Intracranial Aneurysm
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Next Generation Neuroform Stent System
Sponsored by
About this trial
This is an interventional treatment trial for Intracranial Aneurysm focused on measuring Next Generation Neuroform Stent System, Wide Neck, Intracranial, Saccular Aneurysms, Cerebral Aneurysms
Eligibility Criteria
Inclusion Criteria:
- Subject is between 18 and 80 years of age
- Documented wide neck (neck ≥ 4 mm or a dome-to-neck ratio of < 2), intracranial, saccular aneurysm arising from a parent vessel with a diameter of ≥ 2mm and ≤ 4.5 mm, which will be treated with bare metal coils
- Subject or legal representative is willing and able to provide informed consent
- Subject is willing and able to comply with protocol follow-up requirements
Exclusion Criteria:
- Known multiple untreated cerebral aneurysms, other than non-target blister aneurysm, infundibulum, or aneurysm measuring <3mm for each of three dimensions assessed (height, width, and depth) that will not require treatment during the study period
- Target lesion is a blister aneurysm, infundibulum, or aneurysm measuring <3mm for each of three dimensions assessed (height, width, and depth)
- Target aneurysm that will require an Investigator to intentionally leave a neck remnant in order to preserve blood flow in a bifurcation or branch
- Coiling or stenting of a non-target intracranial aneurysm within 30 days prior to study treatment
- Target aneurysm is in the anterior circulation proximal to the superior hypophyseal ICA
- Acute target aneurysm rupture less than 14 days prior to study treatment
- Hunt and Hess score ≥ 3 or a premorbid mRS score ≥4
- An admission platelet count of <50,000, any known coagulopathy, or an International Normalized Ratio (INR)>3.0 without oral anticoagulation therapy
- A known absolute contraindication to angiography
- Evidence of active cancer, terminal illness or any condition which, in the opinion of the treating physician, would/could prevent subject from completing the study (e.g., a high risk of embolic stroke, atrial fibrillation, co-morbidities, psychiatric disorders, substance abuse, major surgery ≤ 30 days pre-procedure, etc.)
- Known absolute contraindication to the use of required study medications or agents (e.g., heparin, aspirin, clopidogrel, and radiographic contrast agents, etc.)
- Female subject who is pregnant or intends to become pregnant during the study
- Moya-Moya disease, arteriovenous malformation(s), arteriovenous fistula(e), intracranial tumor(s), or intracranial hematoma(s) (unrelated to target aneurysm)
- Significant atherosclerotic stenosis, significant vessel tortuosity, vasospasm refractory to medication, unfavorable aneurysm morphology or vessel anatomy, or some other condition(s) that, in the opinion of the treating physician, would/could prevent or interfere with access to the target aneurysm and/or successful deployment of the Neuroform Atlas™ Stent
- Previous treatment (e.g., surgery, stenting) in the parent artery that, in the opinion of the treating physician, would/could prevent or interfere with successful use of the Neuroform Atlas™ Stent System and/or successful adjunctive deployment of embolic coils
- Previous stent-assisted coiling of the target aneurysm
Sites / Locations
- Cedars-Sinai Medical Center
- Vascular Neurology of Southern California
- Radiology Imaging Associates
- Christiana Care Health Services
- Lyerly Neurosurgery
- WellStar Kennestone Hospital
- Rush University Medical Center
- University of Kentucky Research Foundation
- The Johns Hopkins University
- Tufts Medical Center
- Beth Israel Deaconess Medical Center
- University of Massachusetts Medical School
- SSM Health DePaul Hospital
- SUNY University at Buffalo Neurosurgery/Gates Vascular Institute
- The Cleveland Clinic Foundation
- Mercy Health - St. Vincent Medical Center
- Hospital of the University of Pennsylvania
- University of Pittsburgh Medical Center
- Medical University of South Carolina
- Methodist Healthcare - Memphis Hospitals
- Vanderbilt University Medical Center
- Baylor St. Luke's Medical Center
- Houston Methodist Hospital
- Virginia Commonwealth University
- Harborview Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Next Generation Neuroform Stent System
Arm Description
The Next Generation Stent System is a self-expanding, open cell, nitinol stent designed to provide support of the coil mass within the aneurysm and minimize stent deflection.
Outcomes
Primary Outcome Measures
Stroke or Death
Any major ipsilateral stroke or neurological death
Aneurysm Occlusion of the Treated Target Lesion on 12 Month Angiography
Complete aneurysm occlusion (100% occlusion - Raymond Class 1) of the treated target lesion on 12 month angiography, in the absence of retreatment, or parent artery stenosis (> 50%) at the target location.
Secondary Outcome Measures
The Percent of Subjects Experiencing One or More Serious Adverse Events (SAEs) Through 12 Months
The percent of subjects experiencing one or more serious adverse events (SAEs) through 12 months including
New or worsening major ipsilateral stroke as measured by the National Institute of Health Stroke Scale (NIHSS)
Device-related SAEs
Subarachnoid hemorrhage (SAH)
Aneurysm rupture
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02340585
Brief Title
Neuroform Atlas Stent System Study
Acronym
ATLAS
Official Title
Safety and Effectiveness of the Treatment of Wide Neck, Intracranial, Saccular Aneurysms With the Next Generation Neuroform Stent System
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
June 18, 2015 (Actual)
Primary Completion Date
December 13, 2021 (Actual)
Study Completion Date
September 30, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stryker Neurovascular
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The primary objective of this study is to demonstrate effectiveness and safety of the Neuroform Atlas Stent System for use with bare metal embolic coils.
Detailed Description
The study is a prospective, multicenter, open-label, single arm trial designed to demonstrate the potential treatment of wide neck, intracranial, saccular aneurysms with the Next Generation Neuroform Stent System with any approved embolic coils currently on the market. The study will evaluate the percent occlusion of the treated target lesion on angiography in the absence of retreatment, or parent artery stenosis at the target location at 12 months. Subjects with documented wide neck, intracranial, saccular aneurysms arising from a parent artery may potentially benefit from stent assisted coiling, provided they meet the other eligibility criteria.
Data collected through the 12-month follow-up visit are intended to support Premarket Approval (PMA) application to the Food and Drug Administration (FDA). Long-term follow-up data collected through 3 years postoperative are intended to support post-approval study (PAS) requirements.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intracranial Aneurysm
Keywords
Next Generation Neuroform Stent System, Wide Neck, Intracranial, Saccular Aneurysms, Cerebral Aneurysms
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
298 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Next Generation Neuroform Stent System
Arm Type
Experimental
Arm Description
The Next Generation Stent System is a self-expanding, open cell, nitinol stent designed to provide support of the coil mass within the aneurysm and minimize stent deflection.
Intervention Type
Device
Intervention Name(s)
Next Generation Neuroform Stent System
Intervention Description
The Next Generation Neuroform Stent System is pre-loaded on a stent delivery wire and protected by a transfer sheath. An accessory pouch containing an optional stabilizer may be attached to the proximal end of the stent delivery wire to facilitate handling and stabilization.
Primary Outcome Measure Information:
Title
Stroke or Death
Description
Any major ipsilateral stroke or neurological death
Time Frame
within 12 months of the index procedure
Title
Aneurysm Occlusion of the Treated Target Lesion on 12 Month Angiography
Description
Complete aneurysm occlusion (100% occlusion - Raymond Class 1) of the treated target lesion on 12 month angiography, in the absence of retreatment, or parent artery stenosis (> 50%) at the target location.
Time Frame
12 month post index procedure
Secondary Outcome Measure Information:
Title
The Percent of Subjects Experiencing One or More Serious Adverse Events (SAEs) Through 12 Months
Description
The percent of subjects experiencing one or more serious adverse events (SAEs) through 12 months including
New or worsening major ipsilateral stroke as measured by the National Institute of Health Stroke Scale (NIHSS)
Device-related SAEs
Subarachnoid hemorrhage (SAH)
Aneurysm rupture
Time Frame
within 12 months post procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject is between 18 and 80 years of age
Documented wide neck (neck ≥ 4 mm or a dome-to-neck ratio of < 2), intracranial, saccular aneurysm arising from a parent vessel with a diameter of ≥ 2mm and ≤ 4.5 mm, which will be treated with bare metal coils
Subject or legal representative is willing and able to provide informed consent
Subject is willing and able to comply with protocol follow-up requirements
Exclusion Criteria:
Known multiple untreated cerebral aneurysms, other than non-target blister aneurysm, infundibulum, or aneurysm measuring <3mm for each of three dimensions assessed (height, width, and depth) that will not require treatment during the study period
Target lesion is a blister aneurysm, infundibulum, or aneurysm measuring <3mm for each of three dimensions assessed (height, width, and depth)
Target aneurysm that will require an Investigator to intentionally leave a neck remnant in order to preserve blood flow in a bifurcation or branch
Coiling or stenting of a non-target intracranial aneurysm within 30 days prior to study treatment
Target aneurysm is in the anterior circulation proximal to the superior hypophyseal ICA
Acute target aneurysm rupture less than 14 days prior to study treatment
Hunt and Hess score ≥ 3 or a premorbid mRS score ≥4
An admission platelet count of <50,000, any known coagulopathy, or an International Normalized Ratio (INR)>3.0 without oral anticoagulation therapy
A known absolute contraindication to angiography
Evidence of active cancer, terminal illness or any condition which, in the opinion of the treating physician, would/could prevent subject from completing the study (e.g., a high risk of embolic stroke, atrial fibrillation, co-morbidities, psychiatric disorders, substance abuse, major surgery ≤ 30 days pre-procedure, etc.)
Known absolute contraindication to the use of required study medications or agents (e.g., heparin, aspirin, clopidogrel, and radiographic contrast agents, etc.)
Female subject who is pregnant or intends to become pregnant during the study
Moya-Moya disease, arteriovenous malformation(s), arteriovenous fistula(e), intracranial tumor(s), or intracranial hematoma(s) (unrelated to target aneurysm)
Significant atherosclerotic stenosis, significant vessel tortuosity, vasospasm refractory to medication, unfavorable aneurysm morphology or vessel anatomy, or some other condition(s) that, in the opinion of the treating physician, would/could prevent or interfere with access to the target aneurysm and/or successful deployment of the Neuroform Atlas™ Stent
Previous treatment (e.g., surgery, stenting) in the parent artery that, in the opinion of the treating physician, would/could prevent or interfere with successful use of the Neuroform Atlas™ Stent System and/or successful adjunctive deployment of embolic coils
Previous stent-assisted coiling of the target aneurysm
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Osama Zaidat, MD
Organizational Affiliation
Mercy Health - St. Vincent Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Brian Jankowitz, MD
Organizational Affiliation
Cooper University Health Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Vascular Neurology of Southern California
City
Thousand Oaks
State/Province
California
ZIP/Postal Code
91360
Country
United States
Facility Name
Radiology Imaging Associates
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Christiana Care Health Services
City
Newark
State/Province
Delaware
ZIP/Postal Code
19718
Country
United States
Facility Name
Lyerly Neurosurgery
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
WellStar Kennestone Hospital
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Kentucky Research Foundation
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40506
Country
United States
Facility Name
The Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
University of Massachusetts Medical School
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
SSM Health DePaul Hospital
City
Bridgeton
State/Province
Missouri
ZIP/Postal Code
63044
Country
United States
Facility Name
SUNY University at Buffalo Neurosurgery/Gates Vascular Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14203
Country
United States
Facility Name
The Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Mercy Health - St. Vincent Medical Center
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43608
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15219
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29403
Country
United States
Facility Name
Methodist Healthcare - Memphis Hospitals
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38104
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37240
Country
United States
Facility Name
Baylor St. Luke's Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Virginia Commonwealth University
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
33722961
Citation
Jankowitz BT, Jadhav AP, Gross B, Jovin TG, Alhajeri AA, Fraser JF, Hanel RA, Sauvageau E, Aghaebrahim A, Frei D, Bellon R, Loy D, Puri AS, Malek AM, Thomas A, Toth G, Lopes DK, Crowley RW, Arthur AS, Reavey-Cantwell J, Lin E, Siddiqui AH, Alexander MJ, Khaldi A, Colby GP, Caplan JM, Satti SR, Turk AS, Spiotta AM, Klucznik R, Hallam DK, Kung D, Froehler MT, Callison RC, Kan P, Hetts SW, Zaidat OO. Pivotal trial of the Neuroform Atlas stent for treatment of posterior circulation aneurysms: one-year outcomes. J Neurointerv Surg. 2022 Feb;14(2):143-148. doi: 10.1136/neurintsurg-2020-017115. Epub 2021 Mar 15.
Results Reference
derived
PubMed Identifier
32568654
Citation
Zaidat OO, Hanel RA, Sauvageau EA, Aghaebrahim A, Lin E, Jadhav AP, Jovin TG, Khaldi A, Gupta RG, Johnson A, Frei D, Loy D, Malek A, Toth G, Siddiqui A, Reavey-Cantwell J, Thomas A, Hetts SW, Jankowitz BT; ATLAS Investigators. Pivotal Trial of the Neuroform Atlas Stent for Treatment of Anterior Circulation Aneurysms: One-Year Outcomes. Stroke. 2020 Jul;51(7):2087-2094. doi: 10.1161/STROKEAHA.119.028418. Epub 2020 Jun 17.
Results Reference
derived
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Neuroform Atlas Stent System Study
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