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Coating to Optimize Aneurysm Treatment In The New Flow Diverter Generation (COATING)

Primary Purpose

Intracranial Aneurysm

Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Endovascular treatment of unruptured aneurysms with p64 MW HPC Flow Modulation Device
Sponsored by
Phenox GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intracranial Aneurysm

Eligibility Criteria

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

Inclusion Criteria:

  1. At least 18 years of age.
  2. Subject has a saccular, unruptured or recanalized intracranial aneurysm. The subject may also have a previous ruptured aneurysm, provided rupture of this aneurysm 30 days from the index procedure.
  3. Subject is intended to be treated for only one target aneurysm during the index procedure except for segmental disease (multiple aneurysms located on the same arterial segment aimed to be treated with one investigational device or investigational telescopic devices).
  4. Subject has already been selected for flow diversion therapy as the appropriate treatment.
  5. Subject has a mRS ≤ 2 before the procedure, as determined by a certified assessor independent of the index procedure.
  6. Subject is able to understand the patient information and provides written informed consent verifying the use of his/her data (according to data protection laws).

Exclusion Criteria:

  1. Subject who is currently prescribed under any long lasting antiplatelet and/or anticoagulation medication.
  2. Subject has undergone a surgery including endovascular procedures in the last 30 days prior to the study procedure.
  3. Subject has had an Intracranial hemorrhage and/or subarachnoid hemorrhage in the past 30 days prior to the study procedure.
  4. Subject with target aneurysm previously treated with a stent or flow diverter.
  5. Subject is expected to be treated for another aneurysm during the 30 days following the index procedure.
  6. Subject with a confirmed stenosis in parent artery.
  7. Subject with a blister-like aneurysm, fusiform aneurysm, dissecting aneurysm or aneurysm associated with a brain arteriovenous malformation (AVM).
  8. Subject has a pre-procedure mRS >2.
  9. Any known contraindication to treatment with the p64 MW HPC Flow Modulation Device in accordance with device IFU.
  10. Subject who has undergone stenting of the ipsilateral carotid artery within 3 months of the index procedure.
  11. Known serious sensitivity to radiographic contrast agents.
  12. Known sensitivity to nickel, titanium metals, or their alloys.
  13. Subject already enrolled in other clinical trials (including COATING study) that would interfere with study endpoints.
  14. Known renal failure as defined by a serum creatinine > 2.5 mg/dl (or 220 μmol/l) or glomerular filtration rate (GFR) < 30.
  15. Subject who has a contraindication to MRI or angiography for whatever reason.
  16. 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.
  17. Subject with any known allergy to heparin, ASA or other antiplatelet medications.
  18. Pregnant woman or breast feeding.
  19. Adults who lack the capacity to provide informed consent, and all those persons deprived of their liberty in prisons or other places of detention.

Sites / Locations

  • CHU BordeauxRecruiting
  • Hôpital BicêtreRecruiting
  • CHU de Lyon
  • CHU de Montpellier
  • CHU Reims - Hôpital Maison BlancheRecruiting
  • CHU Toulouse
  • Universitätsklinikum Leipzig
  • Universitätsklinikum Augsburg
  • Helios Klinikum Erfurt
  • Klinikum Nürnberg Süd
  • Klinikum StuttgartRecruiting
  • Hadassah University Medical Center
  • Fondazione I.R.C.C.S. Instituto Neurologico Carlo Besta
  • Ospedale San Carlo Borromeo di Milano
  • Universitätsspital BaselRecruiting
  • Queen Elisabeth Hospital BirminghamRecruiting
  • Western General HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

p64 MW HPC Flow Diverter + SAPT

p64 MW Flow Diverter + DAPT

Arm Description

Outcomes

Primary Outcome Measures

Number of DWI lesions
Number of diffusion-weighted imaging (DWI) lesions within 48 hours (+/- 24 hours) of the index procedure visualized via MRI.

Secondary Outcome Measures

Short-term morbi-mortality rate
Morbi-mortality rate at 30 days assessed by mRS > 2
Rate of neurological death or major stroke
Rate of neurological death or major stroke (ischemic or hemorrhagic, defined as an increase of 4 or more points according to the National Institute of Health Stroke Scale Score) in the territory supplied by the treated artery, as assessed by the Clinical Events Committee
Long-term morbi-mortality rate
Rate of subjects who have a mRS decline to a score of 3 or more (mRS > 3), or an increase of 2 points from baseline mRS score, as assessed by the Clinical Events Committee
Rate of subjects with dissusion-weighted imaging (DWI) lesions
Rate of subjects with greater than 6 diffusion-weighted imaging (DWI) lesions or territorial stroke
Delayed aneurysm rupture
Rate of an intracranial hemorrhage from delayed aneurysm rupture (from the day after index procedure), as assessed by the Clinical Events Committee
Delayed intraparenchymal hemorrhage
Rate of delayed intraparenchymal haemorrhage unrelated to aneurysm rupture, as assessed by the Clinical Events Committee
Rate of device deployment at the target site without technical complications
Rate of device deployment at the target site without technical complications, as assessed by the site
Rate of complete aneurysm occlusion
Rate of complete aneurysm occlusion using the 3-grade scale, as assessed by the Core Lab
Rate of target aneurysm recurrence
Rate of target aneurysm recurrence, as assessed by the Imaging Core Lab
Rate of target aneurysm retreatment
Rate of target aneurysm retreatment, as assessed by the Clinical Event Committee
Rate of intrastent stenosis and/or thrombosis at the target site
Rate of intrastent stenosis and/or thrombosis at the target site, as assessed by the Core Lab through DSA
Mean length of hospital stay
Mean length of hospital stay (from hospital admission and up to hospital discharge)

Full Information

First Posted
April 26, 2021
Last Updated
December 2, 2022
Sponsor
Phenox GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04870047
Brief Title
Coating to Optimize Aneurysm Treatment In The New Flow Diverter Generation
Acronym
COATING
Official Title
Coating to Optimize Aneurysm Treatment In The New Flow Diverter Generation
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 3, 2021 (Actual)
Primary Completion Date
July 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Phenox GmbH

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
To assess safety and efficacy of p64 MW HPC Flow Modulation Device under single antiplatelet therapy compared to p64 MW Flow Modulation Device under dual antiplatelet therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intracranial Aneurysm

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
170 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
p64 MW HPC Flow Diverter + SAPT
Arm Type
Experimental
Arm Title
p64 MW Flow Diverter + DAPT
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Endovascular treatment of unruptured aneurysms with p64 MW HPC Flow Modulation Device
Intervention Description
Patients suffering from a distal intracranial aneurysm will be treated endovascularly with the p64 MW HPC Flow Modulation Device.
Primary Outcome Measure Information:
Title
Number of DWI lesions
Description
Number of diffusion-weighted imaging (DWI) lesions within 48 hours (+/- 24 hours) of the index procedure visualized via MRI.
Time Frame
48 hours (± 24 hours)
Secondary Outcome Measure Information:
Title
Short-term morbi-mortality rate
Description
Morbi-mortality rate at 30 days assessed by mRS > 2
Time Frame
30 days (± 7 days)
Title
Rate of neurological death or major stroke
Description
Rate of neurological death or major stroke (ischemic or hemorrhagic, defined as an increase of 4 or more points according to the National Institute of Health Stroke Scale Score) in the territory supplied by the treated artery, as assessed by the Clinical Events Committee
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Long-term morbi-mortality rate
Description
Rate of subjects who have a mRS decline to a score of 3 or more (mRS > 3), or an increase of 2 points from baseline mRS score, as assessed by the Clinical Events Committee
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Rate of subjects with dissusion-weighted imaging (DWI) lesions
Description
Rate of subjects with greater than 6 diffusion-weighted imaging (DWI) lesions or territorial stroke
Time Frame
48 hours (± 24 hours)
Title
Delayed aneurysm rupture
Description
Rate of an intracranial hemorrhage from delayed aneurysm rupture (from the day after index procedure), as assessed by the Clinical Events Committee
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Delayed intraparenchymal hemorrhage
Description
Rate of delayed intraparenchymal haemorrhage unrelated to aneurysm rupture, as assessed by the Clinical Events Committee
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Rate of device deployment at the target site without technical complications
Description
Rate of device deployment at the target site without technical complications, as assessed by the site
Time Frame
During intervention
Title
Rate of complete aneurysm occlusion
Description
Rate of complete aneurysm occlusion using the 3-grade scale, as assessed by the Core Lab
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Rate of target aneurysm recurrence
Description
Rate of target aneurysm recurrence, as assessed by the Imaging Core Lab
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Rate of target aneurysm retreatment
Description
Rate of target aneurysm retreatment, as assessed by the Clinical Event Committee
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Rate of intrastent stenosis and/or thrombosis at the target site
Description
Rate of intrastent stenosis and/or thrombosis at the target site, as assessed by the Core Lab through DSA
Time Frame
180 days (150 - 240 days) and 365 days (335 - 456 days) post procedure
Title
Mean length of hospital stay
Description
Mean length of hospital stay (from hospital admission and up to hospital discharge)
Time Frame
From admission up to discharge, assessed up to 456 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At least 18 years of age. Subject has a saccular, unruptured or recanalized intracranial aneurysm. The subject may also have a previous ruptured aneurysm, provided rupture of this aneurysm 30 days from the index procedure. Subject is intended to be treated for only one target aneurysm during the index procedure except for segmental disease (multiple aneurysms located on the same arterial segment aimed to be treated with one investigational device or investigational telescopic devices). Subject has already been selected for flow diversion therapy as the appropriate treatment. Subject has a mRS ≤ 2 before the procedure, as determined by a certified assessor independent of the index procedure. Subject is able to understand the patient information and provides written informed consent verifying the use of his/her data (according to data protection laws). Exclusion Criteria: Subject who is currently prescribed under any long lasting antiplatelet and/or anticoagulation medication. Subject has undergone a surgery including endovascular procedures in the last 30 days prior to the study procedure. Subject has had an Intracranial hemorrhage and/or subarachnoid hemorrhage in the past 30 days prior to the study procedure. Subject with target aneurysm previously treated with a stent or flow diverter. Subject is expected to be treated for another aneurysm during the 30 days following the index procedure. Subject with a confirmed stenosis in parent artery. Subject with a blister-like aneurysm, fusiform aneurysm, dissecting aneurysm or aneurysm associated with a brain arteriovenous malformation (AVM). Subject has a pre-procedure mRS >2. Any known contraindication to treatment with the p64 MW HPC Flow Modulation Device in accordance with device IFU. Subject who has undergone stenting of the ipsilateral carotid artery within 3 months of the index procedure. Known serious sensitivity to radiographic contrast agents. Known sensitivity to nickel, titanium metals, or their alloys. Subject already enrolled in other clinical trials (including COATING study) that would interfere with study endpoints. Known renal failure as defined by a serum creatinine > 2.5 mg/dl (or 220 μmol/l) or glomerular filtration rate (GFR) < 30. Subject who has a contraindication to MRI or angiography for whatever reason. 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. Subject with any known allergy to heparin, ASA or other antiplatelet medications. Pregnant woman or breast feeding. Adults who lack the capacity to provide informed consent, and all those persons deprived of their liberty in prisons or other places of detention.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nicole Lobitz, Dr.
Phone
+49 234 36919
Ext
0
Email
COATING@phenox.info
First Name & Middle Initial & Last Name or Official Title & Degree
Lena Oettinghaus, Dr.
Phone
+49 234 36919
Ext
0
Email
COATING@phenox.info
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Laurent Pierot, Prof. Dr.
Organizational Affiliation
CHRU Hôpital Maison-Blanche
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU Bordeaux
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xavier Barreau, Dr.
Facility Name
Hôpital Bicêtre
City
Le Kremlin-Bicêtre
ZIP/Postal Code
94270
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laurent Spelle, Prof.
Facility Name
CHU de Lyon
City
Lyon
ZIP/Postal Code
69002
Country
France
Individual Site Status
Active, not recruiting
Facility Name
CHU de Montpellier
City
Montpellier
ZIP/Postal Code
34090
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Vincent Costalat, Prof.
Facility Name
CHU Reims - Hôpital Maison Blanche
City
Reims
ZIP/Postal Code
51092
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laurent Pierot, Prof.
Facility Name
CHU Toulouse
City
Toulouse
ZIP/Postal Code
31059
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christophe Cognard, Prof.
Facility Name
Universitätsklinikum Leipzig
City
Leipzig
State/Province
Sachsen
ZIP/Postal Code
04103
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Matthias Gawlitza, PD Dr.
Facility Name
Universitätsklinikum Augsburg
City
Augsburg
ZIP/Postal Code
86156
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ansgar Berlis, Prof.
Facility Name
Helios Klinikum Erfurt
City
Erfurt
ZIP/Postal Code
99089
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joachim Klisch, Prof.
Facility Name
Klinikum Nürnberg Süd
City
Nürnberg
ZIP/Postal Code
90471
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Markus Holtmannspötter, Dr.
Facility Name
Klinikum Stuttgart
City
Stuttgart
ZIP/Postal Code
70174
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Victoria Hellstern, Dr.
Facility Name
Hadassah University Medical Center
City
Jerusalem
ZIP/Postal Code
9112001
Country
Israel
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jose Cohen, Dr.
Facility Name
Fondazione I.R.C.C.S. Instituto Neurologico Carlo Besta
City
Milan
ZIP/Postal Code
20133
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elisa Francesca Maria Ciceri, Dr.
Facility Name
Ospedale San Carlo Borromeo di Milano
City
Milan
ZIP/Postal Code
20153
Country
Italy
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Luca Valvassori, Dr.
Facility Name
Universitätsspital Basel
City
Basel
ZIP/Postal Code
4051
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marios-Nikos Psychogios, Prof. Dr.
Facility Name
Queen Elisabeth Hospital Birmingham
City
Birmingham
ZIP/Postal Code
B15 2GW
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Saleh Lamin, Dr.
Facility Name
Western General Hospital
City
Edinburgh
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Keston, Dr.

12. IPD Sharing Statement

Citations:
PubMed Identifier
35609974
Citation
Pierot L, Lamin S, Barreau X, Berlis A, Ciceri E, Cohen JE, Costalat V, Eker OF, Henkes H, Holtmannspotter M, Januel AC, Keston P, Klisch J, Psychogios MN, Valvassori L, Cognard C, Spelle L. Coating (Coating to Optimize Aneurysm Treatment in the New Flow Diverter Generation) study. The first randomized controlled trial evaluating a coated flow diverter (p64 MW HPC): study design. J Neurointerv Surg. 2023 Jul;15(7):684-688. doi: 10.1136/neurintsurg-2022-018969. Epub 2022 May 24.
Results Reference
derived

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Coating to Optimize Aneurysm Treatment In The New Flow Diverter Generation

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