Vesalio NeVa VS for Symptomatic Cerebral Vasospasm Following aSAH (The VITAL Study)
Primary Purpose
Cerebral Vasospasm
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NeVa VS
Sponsored by
About this trial
This is an interventional treatment trial for Cerebral Vasospasm
Eligibility Criteria
Inclusion Criteria
- Age ≥ 18 years.
- Subarachnoid hemorrhage secondary to ruptured aneurysm.
- Ruptured aneurysm secured with surgical clipping or endovascular intervention.
- Digital subtraction angiography (DSA) or CT angiography at the time of aSAH clinical presentation or aSAH intervention with well-visualized intra-cerebral vessels is available for review.
- Vasospasm in one or more of the following: the internal carotid artery (ICA), basilar, middle cerebral artery (MCA), anterior cerebral artery (ACA), or posterior cerebral artery (PCA) territory on transcranial Doppler (TCD), and/or CT angiography, and/or clinical signs of symptomatic vasospasm (change in level of consciousness, focal neurological deficit) confirmed by > 50% narrowing in these territories on DSA.
- Vasospasm despite maximized medical management defined as oral Nimodipine (unless contraindicated), systemic hypertension with SBP greater than 130 mmHg and euvolemia.
- Target vessel pre-vasospasm diameter ≥ 2 mm and ≤ 4.0 mm.
- Subject or legal representative is able and willing to give informed consent.
Exclusion Criteria
- The presence of an unsecured ruptured aneurysm. Note unsecured unruptured aneurysms remote to the site of treated aSAH are not an exclusionary.
- Symptoms attributable to other causes (e.g., hydrocephalus, metabolic, infection).
- Hunt and Hess Grade of 5
- Large infarct on CT scan defined as ASPECTS 0-5.
- Intracranial hemorrhage not caused by aneurysm rupture.
- History of bleeding disorders.
- Baseline platelets < 30,000.
- International normalized ratio (INR) > 1.7.
- Any known contraindications to mechanical dilation of vasospastic vessels including but not limited to:
- Excessive vessel tortuosity that prevents the placement of the device
- Evidence of rapidly improving neurological signs of stroke
- Large territory completed cerebral infarction, edema with mass effect and intra-parenchymal hemorrhage in vascular territory to be treated, or
- any other vascular anatomic variants or anomalies
- Pre-existing neurological or psychiatric disease that would confound the neurological or functional evaluations, e.g. dementia with prescribed anti-cholinesterase inhibitor (e.g. Aricept).
- History of severe allergy to contrast medium.
- Known allergy to NeVa materials (nitinol, stainless steel).
- Suspected or confirmed septic embolus, or bacterial endocarditis.
- Septic shock or central nervous system (CNS) infection confirmed via cerebrospinal fluid (CSF) sampling.
- Known current or recent use of illicit drugs or alcohol abuse.
- Females who are pregnant or breastfeeding.
- Any other condition that, in the opinion of the investigator, precludes an endovascular procedure or poses a significant hazard to the subject if an endovascular procedure is performed.
Sites / Locations
- RIA Neurovascular Clinic
- Baptist Health System
- Wellstar Health System
- University of Buffalo
- North Shore University Hospital - Northwell
- Mount Sinai Health System
- SUNY Stony Brook University
- Fort Sanders Regional Med Center
- TTUHSC El Paso
- Houston Methodist Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Intervention
Arm Description
NeVa VS
Outcomes
Primary Outcome Measures
Procedural Success
defined as 50% or greater vessel caliber on DSA compared to baseline, as determined by the core laboratory
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03611790
Brief Title
Vesalio NeVa VS for Symptomatic Cerebral Vasospasm Following aSAH (The VITAL Study)
Official Title
The Vesalio Neva VS for the Treatment of Symptomatic Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage (aSAH) (The VITAL Study)
Study Type
Interventional
2. Study Status
Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
December 19, 2018 (Actual)
Primary Completion Date
May 31, 2021 (Actual)
Study Completion Date
May 31, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vesalio
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of the study is to assess the safety and probable benefit of the Neva VS device in patients presenting with symptomatic cerebral vasospasm despite maximal medical management following aSAH.
Detailed Description
This is a prospective, open label, single-arm study. Up to 30 eligible subjects at up to 15 sites will participate in the study. Subjects will be followed up for 30 days post-intervention.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cerebral Vasospasm
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Intervention
Arm Type
Experimental
Arm Description
NeVa VS
Intervention Type
Device
Intervention Name(s)
NeVa VS
Intervention Description
mechanical dilatation
Primary Outcome Measure Information:
Title
Procedural Success
Description
defined as 50% or greater vessel caliber on DSA compared to baseline, as determined by the core laboratory
Time Frame
within 30 minutes of completion of procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Age ≥ 18 years.
Subarachnoid hemorrhage secondary to ruptured aneurysm.
Ruptured aneurysm secured with surgical clipping or endovascular intervention.
Digital subtraction angiography (DSA) or CT angiography at the time of aSAH clinical presentation or aSAH intervention with well-visualized intra-cerebral vessels is available for review.
Vasospasm in one or more of the following: the internal carotid artery (ICA), basilar, middle cerebral artery (MCA), anterior cerebral artery (ACA), or posterior cerebral artery (PCA) territory on transcranial Doppler (TCD), and/or CT angiography, and/or clinical signs of symptomatic vasospasm (change in level of consciousness, focal neurological deficit) confirmed by > 50% narrowing in these territories on DSA.
Vasospasm despite maximized medical management defined as oral Nimodipine (unless contraindicated), systemic hypertension with SBP greater than 130 mmHg and euvolemia.
Target vessel pre-vasospasm diameter ≥ 2 mm and ≤ 4.0 mm.
Subject or legal representative is able and willing to give informed consent.
Exclusion Criteria
The presence of an unsecured ruptured aneurysm. Note unsecured unruptured aneurysms remote to the site of treated aSAH are not an exclusionary.
Symptoms attributable to other causes (e.g., hydrocephalus, metabolic, infection).
Hunt and Hess Grade of 5
Large infarct on CT scan defined as ASPECTS 0-5.
Intracranial hemorrhage not caused by aneurysm rupture.
History of bleeding disorders.
Baseline platelets < 30,000.
International normalized ratio (INR) > 1.7.
Any known contraindications to mechanical dilation of vasospastic vessels including but not limited to:
Excessive vessel tortuosity that prevents the placement of the device
Evidence of rapidly improving neurological signs of stroke
Large territory completed cerebral infarction, edema with mass effect and intra-parenchymal hemorrhage in vascular territory to be treated, or
any other vascular anatomic variants or anomalies
Pre-existing neurological or psychiatric disease that would confound the neurological or functional evaluations, e.g. dementia with prescribed anti-cholinesterase inhibitor (e.g. Aricept).
History of severe allergy to contrast medium.
Known allergy to NeVa materials (nitinol, stainless steel).
Suspected or confirmed septic embolus, or bacterial endocarditis.
Septic shock or central nervous system (CNS) infection confirmed via cerebrospinal fluid (CSF) sampling.
Known current or recent use of illicit drugs or alcohol abuse.
Females who are pregnant or breastfeeding.
Any other condition that, in the opinion of the investigator, precludes an endovascular procedure or poses a significant hazard to the subject if an endovascular procedure is performed.
Facility Information:
Facility Name
RIA Neurovascular Clinic
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Baptist Health System
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Wellstar Health System
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30062
Country
United States
Facility Name
University of Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14204
Country
United States
Facility Name
North Shore University Hospital - Northwell
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Facility Name
Mount Sinai Health System
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
SUNY Stony Brook University
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
Fort Sanders Regional Med Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37916
Country
United States
Facility Name
TTUHSC El Paso
City
El Paso
State/Province
Texas
ZIP/Postal Code
79905
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
12. IPD Sharing Statement
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Vesalio NeVa VS for Symptomatic Cerebral Vasospasm Following aSAH (The VITAL Study)
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