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An EFS Assessing the Electrolytic eCLIPs System for Treatment of Intracranial Aneurysms

Primary Purpose

Aneurysm, Intracranial

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Electrolytic eCLIPs Bifurcation System
Sponsored by
Evasc Medical Systems Corp.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aneurysm, Intracranial focused on measuring Bifurcation aneurysm, Coil retention, Flow diversion

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. 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 with maximal diameter <25mm and has a neck length of > 4mm or dome:neck ratio <2, arising at a bifurcation with branch artery diameters of 1.5mm to 3.25mm:
  2. Patient understands the nature of the procedure and has the capacity to provide informed consent.
  3. Patient is willing to have on-site follow-up evaluations up to 5-yrs
  4. In the clinician's judgement, the aneurysm requires intervention, given risk of rupture or other rationale (as documented on the Screening CRF), and that the patient agrees with that clinician judgement

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 within 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 cardioembolic symptoms such as atrial fibrillation
  7. Patient with any condition that, in the opinion of the treating physician, would place the subject 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. Patient with resistance to P2Y12 agents 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 patient 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. Patient had a subarachnoid haemorrhage within 1 month prior to enrolment date.
  22. Patient has a non-treated arterio-venous malformation in the territory of the target aneurysm.
  23. Patient 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

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Treatment

    Arm Description

    Single arm study - treatment with Electrolytic eCLIPs Bifurcation System

    Outcomes

    Primary Outcome Measures

    Serious Adverse Events following the eCLIPs procedure
    Proportion of subjects experiencing a device-related serious adverse event within 30 days following the procedure

    Secondary Outcome Measures

    Technical Success
    Proportion of subjects with procedural success for the Electrolytic eCLIPs Bifurcation System. Procedural success defined as: access to the aneurysm, successful deployment, implantation of the eCLIPs Implant, and successful neck bridging of the target aneurysm, as judged by core lab evaluation of the procedural angiogram.
    Success of adjuvant coiling
    Proportion of subjects with procedural success for the ability to insert coils into the aneurysm beyond the successfully implanted eCLIPs Implant, and the eCLIPs Implant to satisfactorily retain coils; irrespective of coil density or degree of occlusion.
    Aneurysm Occlusion
    Proportion of subjects with successful aneurysm treatment with the eCLIPs Implant and embolic coils, as measured by aneurysm occlusion of Modified Raymond-Roy Classification of 1 (no aneurysmal opacification) or 2 (residual neck) using DSA
    Major ipsilateral stroke or neurologic death
    Proportion of subjects experiencing major stroke of neurologic death within 30 days, 6 and 12 months following the procedure.
    All device-related adverse events (AEs)
    A quantitative and descriptive summary of all device-related AEs experienced within 30 days, 6 and 12 months following the procedure.
    Deterioration in modified Rankin Scale (mRS) score at Follow up
    Proportion of subjects experiencing deterioration of modified Rankin Scale (mRS) score from baseline to 30 days, 6 and 12 month follow-up. Neurologic evaluation must be performed by independent qualified personnel.
    Assessment of implant migration
    Proportion of subjects with implant migration at 6 and 12 months follow up. Migration is defined as movement of the eCLIPs implant by 5mm compared to the position at implantation per core lab evaluation.
    Assessment of branch artery patency
    Proportion of subjects whose branch arteries (of the target aneurysm) are patent at 6 and 12 month follow up per core lab evaluation.
    Patient Outcomes - Hospitalization length of stay (LOS)
    Mean hospitalization LOS for index procedure.
    Patient Outcomes - Subsequent hospitalization
    Proportion of subjects requiring any subsequent hospitalization related to the index aneurysm.
    Patient Outcomes - Remedial actions required
    Proportion of subjects requiring remedial action for an adverse event during index procedure.
    Patient Outcomes - Reintervention required
    Proportion of subjects with complications, neurologic deterioration or adverse events requiring reintervention.
    Patient Outcomes - Return to baseline or improved functioning
    Proportion of subjects returning to baseline functioning or improved functioning as measured by modified Rankin Scale (mRS). Baseline mRS compared to mRS at follow up.
    Patient Outcomes - Aneurysm recurrence
    Proportion of subjects with index aneurysm recurrence.
    Patient Outcomes - Aneurysm rupture
    Proportion of subjects with index aneurysm rupture.
    Patient Outcomes - Neurologic deterioration
    Proportion of subjects with neurologic deterioration pre-discharge.

    Full Information

    First Posted
    May 10, 2021
    Last Updated
    April 10, 2022
    Sponsor
    Evasc Medical Systems Corp.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04886505
    Brief Title
    An EFS Assessing the Electrolytic eCLIPs System for Treatment of Intracranial Aneurysms
    Official Title
    An Early Feasibility Study Assessing the Safety, Technical Performance, and Efficacy of the Electrolytic eCLIPs Bifurcation System for the Treatment of Intracranial Bifurcation Aneurysms
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Insufficient funds
    Study Start Date
    January 1, 2022 (Anticipated)
    Primary Completion Date
    September 30, 2022 (Anticipated)
    Study Completion Date
    September 1, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Evasc Medical Systems Corp.

    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 purpose of this study is to investigate the feasibility and initial clinical safety of eCLIPs device use for the treatment of wide-necked bifurcation aneurysms. The eCLIPs device is a novel shield like implant that is placed across the neck of the aneurysm and not only facilitates coil retention but also partly obstructs the flow of blood into the aneurysm. This is an early feasibility study, which is a small study investigating an innovative device to gather more clinical data before conducting a larger study. The safety and the effects of the device on the aneurysm will be studied for 12 months after the procedure among 15 patients at approximately 4 participating hospital centers. A larger study will be required to determine the safety and efficacy of the eCLIPs device for the treatment of wide-necked bifurcation aneurysms.
    Detailed Description
    The primary objective of this study is to obtain preliminary confirmation that the eCLIPs Delivery Wire is safe and provides sufficient technical performance in delivering the eCLIPs Implant to distal tortuous anatomies. This study will be a multicentre, open label, single-arm safety, technical performance, and efficacy study of the Electrolytic eCLIPs Bifurcation System in the management of bifurcated intracranial aneurysms (IA). Subjects included in the study will have saccular intracranial aneurysms that arise at or adjacent to a bifurcation, having a neck length of ≥ 4mm or have a dome:neck ratio <2. Aside from the implantation of the eCLIPs Implant, the study will follow usual clinical care practices. The subjects will undergo clinical assessments at pre-discharge and 30 days, as well as clinical assessment and radiographic imaging at 6 and 12 months (Digital Subtraction Angiography; DSA). It is important to note that changes to the investigational device may occur during the course of this early feasibility study. Ongoing results of the study will be evaluated, along with collection of detailed operator feedback on usability, in order to determine whether further refinements to the eCLIPs Delivery Wire are required.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Aneurysm, Intracranial
    Keywords
    Bifurcation aneurysm, Coil retention, Flow diversion

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Treatment
    Arm Type
    Experimental
    Arm Description
    Single arm study - treatment with Electrolytic eCLIPs Bifurcation System
    Intervention Type
    Device
    Intervention Name(s)
    Electrolytic eCLIPs Bifurcation System
    Intervention Description
    The electrolytic eCLIPs bifurcation system will be implanted into patients with bifurcated saccular intra-cranial aneurysms.
    Primary Outcome Measure Information:
    Title
    Serious Adverse Events following the eCLIPs procedure
    Description
    Proportion of subjects experiencing a device-related serious adverse event within 30 days following the procedure
    Time Frame
    Within 30 days of the procedure
    Secondary Outcome Measure Information:
    Title
    Technical Success
    Description
    Proportion of subjects with procedural success for the Electrolytic eCLIPs Bifurcation System. Procedural success defined as: access to the aneurysm, successful deployment, implantation of the eCLIPs Implant, and successful neck bridging of the target aneurysm, as judged by core lab evaluation of the procedural angiogram.
    Time Frame
    During Procedure
    Title
    Success of adjuvant coiling
    Description
    Proportion of subjects with procedural success for the ability to insert coils into the aneurysm beyond the successfully implanted eCLIPs Implant, and the eCLIPs Implant to satisfactorily retain coils; irrespective of coil density or degree of occlusion.
    Time Frame
    During Procedure
    Title
    Aneurysm Occlusion
    Description
    Proportion of subjects with successful aneurysm treatment with the eCLIPs Implant and embolic coils, as measured by aneurysm occlusion of Modified Raymond-Roy Classification of 1 (no aneurysmal opacification) or 2 (residual neck) using DSA
    Time Frame
    At 6 month and 12 month follow-up
    Title
    Major ipsilateral stroke or neurologic death
    Description
    Proportion of subjects experiencing major stroke of neurologic death within 30 days, 6 and 12 months following the procedure.
    Time Frame
    Within12 months of procedure
    Title
    All device-related adverse events (AEs)
    Description
    A quantitative and descriptive summary of all device-related AEs experienced within 30 days, 6 and 12 months following the procedure.
    Time Frame
    Within 12 months of procedure
    Title
    Deterioration in modified Rankin Scale (mRS) score at Follow up
    Description
    Proportion of subjects experiencing deterioration of modified Rankin Scale (mRS) score from baseline to 30 days, 6 and 12 month follow-up. Neurologic evaluation must be performed by independent qualified personnel.
    Time Frame
    30 days, 6, and 12 months following the procedure
    Title
    Assessment of implant migration
    Description
    Proportion of subjects with implant migration at 6 and 12 months follow up. Migration is defined as movement of the eCLIPs implant by 5mm compared to the position at implantation per core lab evaluation.
    Time Frame
    6 and 12 months following procedure
    Title
    Assessment of branch artery patency
    Description
    Proportion of subjects whose branch arteries (of the target aneurysm) are patent at 6 and 12 month follow up per core lab evaluation.
    Time Frame
    6 and 12 months following procedure
    Title
    Patient Outcomes - Hospitalization length of stay (LOS)
    Description
    Mean hospitalization LOS for index procedure.
    Time Frame
    Within 12 months of procedure
    Title
    Patient Outcomes - Subsequent hospitalization
    Description
    Proportion of subjects requiring any subsequent hospitalization related to the index aneurysm.
    Time Frame
    Within 12 months of procedure
    Title
    Patient Outcomes - Remedial actions required
    Description
    Proportion of subjects requiring remedial action for an adverse event during index procedure.
    Time Frame
    Within 12 months of procedure
    Title
    Patient Outcomes - Reintervention required
    Description
    Proportion of subjects with complications, neurologic deterioration or adverse events requiring reintervention.
    Time Frame
    30 days, 6, and 12 months following the procedure
    Title
    Patient Outcomes - Return to baseline or improved functioning
    Description
    Proportion of subjects returning to baseline functioning or improved functioning as measured by modified Rankin Scale (mRS). Baseline mRS compared to mRS at follow up.
    Time Frame
    6 and 12 months following procedure
    Title
    Patient Outcomes - Aneurysm recurrence
    Description
    Proportion of subjects with index aneurysm recurrence.
    Time Frame
    Within 30 days, 6, and 12 months following the procedure
    Title
    Patient Outcomes - Aneurysm rupture
    Description
    Proportion of subjects with index aneurysm rupture.
    Time Frame
    Within 30 days, 6, and 12 months following the procedure
    Title
    Patient Outcomes - Neurologic deterioration
    Description
    Proportion of subjects with neurologic deterioration pre-discharge.
    Time Frame
    Immediate post-procedure prior to discharge

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: 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 with maximal diameter <25mm and has a neck length of > 4mm or dome:neck ratio <2, arising at a bifurcation with branch artery diameters of 1.5mm to 3.25mm: Patient understands the nature of the procedure and has the capacity to provide informed consent. Patient is willing to have on-site follow-up evaluations up to 5-yrs In the clinician's judgement, the aneurysm requires intervention, given risk of rupture or other rationale (as documented on the Screening CRF), and that the patient agrees with that clinician judgement 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 within 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 cardioembolic symptoms such as atrial fibrillation Patient with any condition that, in the opinion of the treating physician, would place the subject 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. Patient with resistance to P2Y12 agents 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 patient 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. Patient had a subarachnoid haemorrhage within 1 month prior to enrolment date. Patient has a non-treated arterio-venous malformation in the territory of the target aneurysm. Patient 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.

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    An EFS Assessing the Electrolytic eCLIPs System for Treatment of Intracranial Aneurysms

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