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European eCLIPS™ Safety, Feasibility and Efficacy Study (EESIS)

Primary Purpose

Saccular Aneurysm, Intracranial Aneurysm

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Implant eCLIPs
Sponsored by
Evasc Medical Systems Corp.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Saccular Aneurysm focused on measuring coil embolization, bifurcation

Eligibility Criteria

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient whose age is greater than 18 years old
  2. Patient with an unruptured or previously ruptured (at least 1 month from date of rupture and with partial occlusion of the dome of the aneurysm by endovascular techniques or by open neurosurgery, and in stable neurological condition-WFNS I and II with a good recovery to at least to mRS 0-2) saccular, intracranial aneurysm or recurrent aneurysm, which arises at a bifurcation of Basilar Tip or Carotid Terminus and has a neck length of > 4mm or dome:neck ratio <2.
  3. Patient aneurysm arises at a bifurcation artery with at least one of the two branch artery vessels having a diameter between 1.5mm and 3.25mm
  4. Patient understands the nature of the procedure and has the capacity to provide informed consent.
  5. Patient is willing to have on-site 30- day, 6-month, and 12 month follow-up evaluations as per standard clinical practice.

Exclusion Criteria:

  1. Patient who presents with an intracranial mass or currently undergoing radiation therapy for carcinoma of the head or neck region.
  2. Major surgery within previous 30 days or planned in the next 120 days after enrolment.
  3. Patient with an International Normalized Ratio (INR)≥ 1.5.
  4. Patient with serum creatinine level ≥104 µmol/L (or 2.5mg/dL) at time of enrolment.
  5. Patient with a platelet count ˂100x103 cells/mm3 or known platelet dysfunction at time of enrolment
  6. Patient who has a known cardiac disorder, likely to be associated with cardio-embolic symptoms such as atrial fibrillation
  7. Patient with any condition that, in the opinion of the treating physician, would place the participant at a high risk of embolic stroke or with any medical co-morbidity likely to affect the outcome (e.g. pulmonary disease, uncontrolled diabetes, blood disorders).
  8. Patient with known allergies to nickel-titanium metal
  9. Patient with known allergies to aspirin, heparin, ticlopidine, clopidogrel, prasugrel or other anti-platelet or P2Y12 agents or to general anesthesia.
  10. Subject has resistance to Prasugrel based on a validated platelet testing method (Verify Now, Multiplate or other).
  11. Patient with a life threatening allergy to contrast (patients with itching or rash as a reaction to contrast can be included if properly prophylactically treated).
  12. Patient with inappropriate anatomy as demonstrated by angiography due to severe intracranial vessel tortuosity or stenosis, or intracranial vasospasm not responsive to medical therapy.
  13. Patient who is currently participating in another clinical research study involving an investigational product.
  14. Patient who has had a previous intracranial procedure associated with the target aneurysm such that access and placement of an eCLIPS device would be compromised
  15. Stenting, angioplasty, or endarterectomy of an extracranial (carotid or vertebral artery) or intracranial artery within 30 days prior to the treatment date.
  16. More than one intracranial aneurysm that requires treatment within 12 months.
  17. Asymptomatic extradural aneurysms requiring treatment.
  18. Severe neurological deficit that renders the subject incapable of living independently.
  19. Unstable neurological deficit (i.e. worsening or improvement of clinical condition in the last 30 days.
  20. Dementia or psychiatric problem that prevents the subject from completing required follow up.
  21. Subject had a subarachnoid haemorrhage within 6 months prior to enrolment date.
  22. Subject has a non-treated arterio-venous malformation in the territory of the target aneurysm.
  23. Subject has a need for long-term use of anticoagulants.
  24. Patient who is unable to complete the required follow-up.
  25. Inability to understand the study or history of non-compliance with medical advice.
  26. Evidence of active infection at the time of treatment.
  27. Patient who is pregnant or breastfeeding.
  28. Patient who has participated in a drug study within the last 30 days.

Sites / Locations

  • Aarhus Universitetshospital
  • Universitaetsklinikum Duesseldorf
  • Maastricht University Hospital
  • Radboudumc

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

eCLIPs BRS

Arm Description

Implant eCLIPs BRS at target aneurysm

Outcomes

Primary Outcome Measures

Safety End Point: absence of a major territorial stroke or death (procedural).
Major territorial stroke was defined as an ischemic or hemorrhagic stroke resulting in an increase of ≥4 points on the NIH Stroke Scale/Score (NIHSS) and that persisted for >24 hours. NIHSS ranges from 0 to 4; with lower scores indicating better outcome.
Absence of a major territorial stroke or neurological death
Major territorial stroke was defined as an ischemic or hemorrhagic stroke resulting in an increase of ≥4 points on the NIH Stroke Scale/Score (NIHSS) and that persisted for >24 hours. NIHSS ranges from 0 to 4; with lower scores indicating better outcome.
Complete aneurysm occlusion (Raymond 1 )
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.
Complete aneurysm occlusion (Raymond 1 )
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.

Secondary Outcome Measures

eCLIPs Bifurcation Remodeling System Technical Success
measured by the proportion of successful eCLIPs Device implants at the target aneurysm
Complete or near complete (Raymond 1 and 2)
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I or II), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.
Degree of Flow Diversion (reduction of blood flow into aneurysm)
reduction of blood flow into aneurysm according to the O'Kelly-Marotta (OKM) grading scale
Success of adjuvant coiling into aneurysm after successful eCLIPs Device implant
Success of adjunctive coiling into aneurysm after successful eCLIPs implantation, assessed by the operator.
Change in Modified Rankin Score
Change in Modified Rankin Score (mRS) from baseline. The mRS ranges from 0 to 6; lower scores indicate better outcome.
Occurrence of unplanned aneurysm re-treatment
endovascular or surgical repair
Assessment of Device Migration
Frequency of eCLIPs Device migration
Assessment of artery stenosis at the device location
Frequency of cases with artery stenosis at the device location
Assessment of artery patency at the target aneurysm
Frequency of cases with artery patency at the target aneurysm

Full Information

First Posted
November 16, 2015
Last Updated
November 22, 2022
Sponsor
Evasc Medical Systems Corp.
Collaborators
Radboud University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02607501
Brief Title
European eCLIPS™ Safety, Feasibility and Efficacy Study
Acronym
EESIS
Official Title
A Multi-center Post Marketing Study Evaluating the Safety, Technical Feasibility, and Efficacy of the eCLIPs™ Family of Products for the Treatment of Bifurcation Intracranial Aneurysms.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Terminated
Why Stopped
Insufficient accrual rate
Study Start Date
April 1, 2016 (Actual)
Primary Completion Date
January 31, 2020 (Actual)
Study Completion Date
September 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Evasc Medical Systems Corp.
Collaborators
Radboud University Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
An open label, prospective, multicentre, single-arm, post marketing study evaluating the safety, technical feasibility, and efficacy of the eCLIPs™ Family of Products for the treatment of bifurcation intracranial aneurysms.
Detailed Description
The objective of this study is to obtain data on the technical feasibility, safety, and efficacy of the eCLIPs™ Products for the treatment of bifurcation aneurysms. Specifically, procedural success of the eCLIPs Bifurcation Remodelling System (BRS) will be evaluated to determine feasibility of this product and safety will be measured as of a major stroke or death within 30 days, or major territorial stroke or neurological death within one year. Additional endpoints will be evaluated and data collected to assess the procedural success of the other eCLIPs Products Microcatheter, Microintroducer, Detacher) and collect efficacy information on the eCLIPs Products. A rate of 69% of aneurysms achieving Raymond Class 1 occlusion at the 12 month endpoint has been chosen as the criterion for success in subjects treated with the eCLIPs Device and coils (primary endpoint). An upper 95% confidence interval of 10% rate of major ipsilateral stroke or death at the 1 month, and 12 month endpoint has been chosen to demonstrate clinically safety (primary endpoint).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Saccular Aneurysm, Intracranial Aneurysm
Keywords
coil embolization, bifurcation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
eCLIPs BRS
Arm Type
Other
Arm Description
Implant eCLIPs BRS at target aneurysm
Intervention Type
Device
Intervention Name(s)
Implant eCLIPs
Intervention Description
Implant eCLIPs at target bifurcation aneurysm
Primary Outcome Measure Information:
Title
Safety End Point: absence of a major territorial stroke or death (procedural).
Description
Major territorial stroke was defined as an ischemic or hemorrhagic stroke resulting in an increase of ≥4 points on the NIH Stroke Scale/Score (NIHSS) and that persisted for >24 hours. NIHSS ranges from 0 to 4; with lower scores indicating better outcome.
Time Frame
30 days
Title
Absence of a major territorial stroke or neurological death
Description
Major territorial stroke was defined as an ischemic or hemorrhagic stroke resulting in an increase of ≥4 points on the NIH Stroke Scale/Score (NIHSS) and that persisted for >24 hours. NIHSS ranges from 0 to 4; with lower scores indicating better outcome.
Time Frame
31 days to 12 months
Title
Complete aneurysm occlusion (Raymond 1 )
Description
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.
Time Frame
6 months
Title
Complete aneurysm occlusion (Raymond 1 )
Description
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
eCLIPs Bifurcation Remodeling System Technical Success
Description
measured by the proportion of successful eCLIPs Device implants at the target aneurysm
Time Frame
Procedural
Title
Complete or near complete (Raymond 1 and 2)
Description
complete aneurysm occlusion (modified Raymond-Roy classification (mRRc) I or II), adjudicated by an independent core laboratory. mRRC ranges from 1 to 3b; where lower scores (1) indicate better outcome.
Time Frame
6 and 12 months
Title
Degree of Flow Diversion (reduction of blood flow into aneurysm)
Description
reduction of blood flow into aneurysm according to the O'Kelly-Marotta (OKM) grading scale
Time Frame
immediately after eCLIPs implant, before coiling
Title
Success of adjuvant coiling into aneurysm after successful eCLIPs Device implant
Description
Success of adjunctive coiling into aneurysm after successful eCLIPs implantation, assessed by the operator.
Time Frame
Procedural
Title
Change in Modified Rankin Score
Description
Change in Modified Rankin Score (mRS) from baseline. The mRS ranges from 0 to 6; lower scores indicate better outcome.
Time Frame
from Baseline to 1 month, 6 months and 12 months
Title
Occurrence of unplanned aneurysm re-treatment
Description
endovascular or surgical repair
Time Frame
within 12 months
Title
Assessment of Device Migration
Description
Frequency of eCLIPs Device migration
Time Frame
at 6 months and 12 months
Title
Assessment of artery stenosis at the device location
Description
Frequency of cases with artery stenosis at the device location
Time Frame
at 6 months and 12 months
Title
Assessment of artery patency at the target aneurysm
Description
Frequency of cases with artery patency at the target aneurysm
Time Frame
at 6 months and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient whose age is greater than 18 years old Patient with an unruptured or previously ruptured (at least 1 month from date of rupture and with partial occlusion of the dome of the aneurysm by endovascular techniques or by open neurosurgery, and in stable neurological condition-WFNS I and II with a good recovery to at least to mRS 0-2) saccular, intracranial aneurysm or recurrent aneurysm, which arises at a bifurcation of Basilar Tip or Carotid Terminus and has a neck length of > 4mm or dome:neck ratio <2. Patient aneurysm arises at a bifurcation artery with at least one of the two branch artery vessels having a diameter between 1.5mm and 3.25mm Patient understands the nature of the procedure and has the capacity to provide informed consent. Patient is willing to have on-site 30- day, 6-month, and 12 month follow-up evaluations as per standard clinical practice. Exclusion Criteria: Patient who presents with an intracranial mass or currently undergoing radiation therapy for carcinoma of the head or neck region. Major surgery within previous 30 days or planned in the next 120 days after enrolment. Patient with an International Normalized Ratio (INR)≥ 1.5. Patient with serum creatinine level ≥104 µmol/L (or 2.5mg/dL) at time of enrolment. Patient with a platelet count ˂100x103 cells/mm3 or known platelet dysfunction at time of enrolment Patient who has a known cardiac disorder, likely to be associated with cardio-embolic symptoms such as atrial fibrillation Patient with any condition that, in the opinion of the treating physician, would place the participant at a high risk of embolic stroke or with any medical co-morbidity likely to affect the outcome (e.g. pulmonary disease, uncontrolled diabetes, blood disorders). Patient with known allergies to nickel-titanium metal Patient with known allergies to aspirin, heparin, ticlopidine, clopidogrel, prasugrel or other anti-platelet or P2Y12 agents or to general anesthesia. Subject has resistance to Prasugrel based on a validated platelet testing method (Verify Now, Multiplate or other). Patient with a life threatening allergy to contrast (patients with itching or rash as a reaction to contrast can be included if properly prophylactically treated). Patient with inappropriate anatomy as demonstrated by angiography due to severe intracranial vessel tortuosity or stenosis, or intracranial vasospasm not responsive to medical therapy. Patient who is currently participating in another clinical research study involving an investigational product. Patient who has had a previous intracranial procedure associated with the target aneurysm such that access and placement of an eCLIPS device would be compromised Stenting, angioplasty, or endarterectomy of an extracranial (carotid or vertebral artery) or intracranial artery within 30 days prior to the treatment date. More than one intracranial aneurysm that requires treatment within 12 months. Asymptomatic extradural aneurysms requiring treatment. Severe neurological deficit that renders the subject incapable of living independently. Unstable neurological deficit (i.e. worsening or improvement of clinical condition in the last 30 days. Dementia or psychiatric problem that prevents the subject from completing required follow up. Subject had a subarachnoid haemorrhage within 6 months prior to enrolment date. Subject has a non-treated arterio-venous malformation in the territory of the target aneurysm. Subject has a need for long-term use of anticoagulants. Patient who is unable to complete the required follow-up. Inability to understand the study or history of non-compliance with medical advice. Evidence of active infection at the time of treatment. Patient who is pregnant or breastfeeding. Patient who has participated in a drug study within the last 30 days.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joost DeVries, M.D.
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Aarhus Universitetshospital
City
Aarhus
Country
Denmark
Facility Name
Universitaetsklinikum Duesseldorf
City
Dusseldorf
Country
Germany
Facility Name
Maastricht University Hospital
City
Maastricht
Country
Netherlands
Facility Name
Radboudumc
City
Nijmegen
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
35393338
Citation
de Vries J, Aquarius R, Sorensen L, Boogaarts HD, Turowski B, van Zwam WH, Marotta TR, Bartels RHMA. Safety and efficacy of the eCLIPs bifurcation remodelling system for the treatment of wide necked bifurcation aneurysms: 1 year results from the European eCLIPs Safety, Feasibility, and Efficacy Study (EESIS). J Neurointerv Surg. 2023 Feb;15(2):163-171. doi: 10.1136/neurintsurg-2021-018460. Epub 2022 Apr 7.
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