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Amnis Therapeutics Thrombectomy Device-First in Man (FIM) Safety and Performance Study

Primary Purpose

Ischemic Stroke

Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Thrombectomy Device
Sponsored by
Amnis Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ischemic Stroke

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged18-85years.
  2. Subject who is contraindicated or failed (when the physician withdraws the tPA per physician discretion) intravenous tissue plasminogen activator (t-PA) therapy given at local institutions or within national practice. Failed means that the physician does not continue with IV tPA after thrombolysis; there is still an occlusion with TICI that is </= 1 as the relevant inclusion criteria.
  3. Subject is able to be treated within 8 hours of stroke symptoms onset with minimum of one deployment of the Amnis Thrombectomy Device.
  4. NIHSS score ≥8.
  5. Pre-stroke mRS (modified Rankin Scale) score of 0 to 1.
  6. Thrombolysis in cerebral infarction (TICI) ≤1 and causative occlusion of the M1 or M2 portion of the MCAs, anterior cerebral arteries, vertebral arteries, basilar artery ,or posterior cerebral arteries (P1 o rP2), confirmed by CT or MR angiography that is accessible to the Amnis thrombectomy device (i.e. according to IFU; 2-5.5 mm).
  7. ASPECTS of ≥6 based on CT or MRI that was performed within 60 min prior to the start of endovascular procedure.
  8. Subject or subject's legal guardian where regulations permit, signs the Patient Informed Consent and agrees that subject will attend follow-up visits.

Exclusion Criteria:

  1. Rapid neurological improvement prior to or at time of treatment suggesting resolution of signs/symptoms of stroke.
  2. Estimated time of symptom onset.
  3. Baseline NIHSS score <8.
  4. BaselineNIHSS score ≥30 or state of coma.
  5. Baseline pre-stroke mRS score >1.
  6. Baseline Thrombolysis in cerebral infarction (TICI) > 2a.
  7. Known serious sensitivity to radiographic contrast agent.
  8. Arterial tortuosity, pre-existing stent and/o rother arterial disease that would prevent the device from reaching the target vessel.
  9. Evidence of a moderate/large core defined as extensive early ischemic changes of Alberta Stroke Program Early CT score (ASPECTS) <6.

    Co-morbid conditions:

  10. Elevated blood pressure(systolic>185 mm Hg or diastolic >110 mm Hg)
  11. Use of warfarin anticoagulation with INR >3.0.
  12. Platelet count <30,000/mm³.
  13. Blood glucose concentration <50 mg/dL (2.7 mmol/L).
  14. CT/MRI imaging demonstrate smultilobar infarction (hypodensity >1/3 cerebral hemisphere).
  15. CT or MRI evidence of mass effect, signs of hemorrhage, arteriovenous malformation or aneurysm or intra-cranial tumor (except small meningioma).
  16. Angiographic evidence of carotid dissection, complete cervical carotid occlusions or vasculitis.
  17. Clinical Symptoms or CT/MRI imaging suggest subarachnoid hemorrhage.
  18. Imaging evidence that suggests, in the opinion of the investigator, the subject is not appropriate for mechanical thrombectomy intervention (e.g. inability to navigate to target lesion, moderate/large infarct with poor collateral circulation, etc.).

    General - related to the protocol or device:

  19. Known sensitivity to nickel, titanium metals or their alloys.
  20. Subject who requires hemodialysis or peritoneal dialysis, or who has a contraindication to an angiogram for whatever reason.
  21. Current participation in another investigational drug or device study.
  22. Female who is pregnant or lactating or has a positive pregnancy test at time of admission.
  23. Subject currently uses or has a recent history of illicit drug(s) or abuses alcohol (defined as regular or daily consumption of more than four alcoholic drinks per day).
  24. Subject has a life expectancy of <90 days.
  25. Subject with a comorbid disease or condition that would confound the neurological and functional evaluations or compromise survival or ability to complete follow-up assessments.

Sites / Locations

  • Hospital Vall d'Hebron; Unidad Ictus
  • Hospital Clinico of Barcelona; Section of Vascular Radiology & Neuroradiology
  • Hospital Clínico Universitario (Valladolid); Dept. Neurology
  • Karolinska Universitetssjukhuset i Solna

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Open arm

Arm Description

Thrombectomy device to be used to retrieve clot and restore blood flow.

Outcomes

Primary Outcome Measures

All serious adverse events (notably at 24 hours ± 3 hrs post procedure or until alternative stroke treatment is initiated, whichever comes first).
It will investigate whether the application of Amnis Thrombectomy device is a safe method, in acute stroke therapy, for obtaining recanalization of large vessels and with favorable patient outcome.
All cause mortality (90 days).
Determine the number of participants with treatment-related adverse events.

Secondary Outcome Measures

Arterial recanalization of the occluded target vessel in the immediate post-procedure angiogram.
Arterial recanalization of the occluded target vessel as angiographically scored by a Thrombolysis in Cerebral Infarction (TICI) flow grade of 2b or greater in the immediate post-procedure angiogram.
Proportion of patients with rapid neurological improvement as determined by a NIHSS ≤4.
Proportion of patients with rapid neurological improvement (more than 4 points on the NIHSS or NIHSS ≤4) during the first 24 hours after treatment.
Good functional clinical outcome as determine by a modified Rankin Scale score of 0-2.
Proportion of patients with rapid neurological improvement (more than 4 points on the NIHSS or NIHSS ≤4) during the first 24 hours after treatment.

Full Information

First Posted
December 5, 2016
Last Updated
July 21, 2022
Sponsor
Amnis Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02994563
Brief Title
Amnis Therapeutics Thrombectomy Device-First in Man (FIM) Safety and Performance Study
Official Title
Amnis Therapeutics Thrombectomy Device-First in Man (FIM) Safety and Performance Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Terminated
Why Stopped
Subject recruitment problem due to Covid pandemic
Study Start Date
October 7, 2019 (Actual)
Primary Completion Date
February 25, 2021 (Actual)
Study Completion Date
March 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amnis Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
Prospective, single-arm, open label, Safety and Performance clinical investigation.
Detailed Description
The Amnis Thrombectomy Device is intended to restore blood flow by removing thrombus from intracranial vessels in patients experiencing ischemic stroke. Pre-CE mark clinical investigation. Population will be subjects with documented untreated, acute ischemic stroke with large vessel occlusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemic Stroke

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Open arm
Arm Type
Experimental
Arm Description
Thrombectomy device to be used to retrieve clot and restore blood flow.
Intervention Type
Device
Intervention Name(s)
Thrombectomy Device
Intervention Description
The Amnis Thrombectomy Device is intended to restore blood flow by removing thrombus from intracranial vessels in patients experiencing ischemic stroke
Primary Outcome Measure Information:
Title
All serious adverse events (notably at 24 hours ± 3 hrs post procedure or until alternative stroke treatment is initiated, whichever comes first).
Description
It will investigate whether the application of Amnis Thrombectomy device is a safe method, in acute stroke therapy, for obtaining recanalization of large vessels and with favorable patient outcome.
Time Frame
24 hours ± 3 hrs post procedure or until alternative stroke treatment is initiated, whichever comes first.
Title
All cause mortality (90 days).
Description
Determine the number of participants with treatment-related adverse events.
Time Frame
3 months post-procedure
Secondary Outcome Measure Information:
Title
Arterial recanalization of the occluded target vessel in the immediate post-procedure angiogram.
Description
Arterial recanalization of the occluded target vessel as angiographically scored by a Thrombolysis in Cerebral Infarction (TICI) flow grade of 2b or greater in the immediate post-procedure angiogram.
Time Frame
Immediate post-procedure angiogram.
Title
Proportion of patients with rapid neurological improvement as determined by a NIHSS ≤4.
Description
Proportion of patients with rapid neurological improvement (more than 4 points on the NIHSS or NIHSS ≤4) during the first 24 hours after treatment.
Time Frame
First 24 hours after treatment
Title
Good functional clinical outcome as determine by a modified Rankin Scale score of 0-2.
Description
Proportion of patients with rapid neurological improvement (more than 4 points on the NIHSS or NIHSS ≤4) during the first 24 hours after treatment.
Time Frame
First 24 hours after treatment.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged18-85years. Subject who is contraindicated or failed (when the physician withdraws the tPA per physician discretion) intravenous tissue plasminogen activator (t-PA) therapy given at local institutions or within national practice. Failed means that the physician does not continue with IV tPA after thrombolysis; there is still an occlusion with TICI that is </= 1 as the relevant inclusion criteria. Subject is able to be treated within 8 hours of stroke symptoms onset with minimum of one deployment of the Amnis Thrombectomy Device. NIHSS score ≥8. Pre-stroke mRS (modified Rankin Scale) score of 0 to 1. Thrombolysis in cerebral infarction (TICI) ≤1 and causative occlusion of the M1 or M2 portion of the MCAs, anterior cerebral arteries, vertebral arteries, basilar artery ,or posterior cerebral arteries (P1 o rP2), confirmed by CT or MR angiography that is accessible to the Amnis thrombectomy device (i.e. according to IFU; 2-5.5 mm). ASPECTS of ≥6 based on CT or MRI that was performed within 60 min prior to the start of endovascular procedure. Subject or subject's legal guardian where regulations permit, signs the Patient Informed Consent and agrees that subject will attend follow-up visits. Exclusion Criteria: Rapid neurological improvement prior to or at time of treatment suggesting resolution of signs/symptoms of stroke. Estimated time of symptom onset. Baseline NIHSS score <8. BaselineNIHSS score ≥30 or state of coma. Baseline pre-stroke mRS score >1. Baseline Thrombolysis in cerebral infarction (TICI) > 2a. Known serious sensitivity to radiographic contrast agent. Arterial tortuosity, pre-existing stent and/o rother arterial disease that would prevent the device from reaching the target vessel. Evidence of a moderate/large core defined as extensive early ischemic changes of Alberta Stroke Program Early CT score (ASPECTS) <6. Co-morbid conditions: Elevated blood pressure(systolic>185 mm Hg or diastolic >110 mm Hg) Use of warfarin anticoagulation with INR >3.0. Platelet count <30,000/mm³. Blood glucose concentration <50 mg/dL (2.7 mmol/L). CT/MRI imaging demonstrate smultilobar infarction (hypodensity >1/3 cerebral hemisphere). CT or MRI evidence of mass effect, signs of hemorrhage, arteriovenous malformation or aneurysm or intra-cranial tumor (except small meningioma). Angiographic evidence of carotid dissection, complete cervical carotid occlusions or vasculitis. Clinical Symptoms or CT/MRI imaging suggest subarachnoid hemorrhage. Imaging evidence that suggests, in the opinion of the investigator, the subject is not appropriate for mechanical thrombectomy intervention (e.g. inability to navigate to target lesion, moderate/large infarct with poor collateral circulation, etc.). General - related to the protocol or device: Known sensitivity to nickel, titanium metals or their alloys. Subject who requires hemodialysis or peritoneal dialysis, or who has a contraindication to an angiogram for whatever reason. Current participation in another investigational drug or device study. Female who is pregnant or lactating or has a positive pregnancy test at time of admission. Subject currently uses or has a recent history of illicit drug(s) or abuses alcohol (defined as regular or daily consumption of more than four alcoholic drinks per day). Subject has a life expectancy of <90 days. Subject with a comorbid disease or condition that would confound the neurological and functional evaluations or compromise survival or ability to complete follow-up assessments.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tommy Andersson, M.D.; Ph.D.
Organizational Affiliation
Karolinska Institute, Neuroradiology Clinic, Stockholm, Sweden
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Vall d'Hebron; Unidad Ictus
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Clinico of Barcelona; Section of Vascular Radiology & Neuroradiology
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Clínico Universitario (Valladolid); Dept. Neurology
City
Valladolid
ZIP/Postal Code
47003
Country
Spain
Facility Name
Karolinska Universitetssjukhuset i Solna
City
Stockholm
ZIP/Postal Code
171 76
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No

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Amnis Therapeutics Thrombectomy Device-First in Man (FIM) Safety and Performance Study

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