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Complete Occlusion of Coilable Aneurysms (COCOA)

Primary Purpose

Intracranial Aneurysm

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Pipeline Embolization Device (PED)
Coil embolization
Sponsored by
Chestnut Medical Technologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intracranial Aneurysm focused on measuring neurovascular embolization, therapeutic embolization

Eligibility Criteria

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

Inclusion Criteria:

  • Age 21 to 75 years, inclusive
  • Patient has a single target IA that:

    1. is located in the following regions of the internal carotid artery: i. Paraophthalmic (including paraclinoid, ophthalmic and hypophyseal segments) ii. Cavernous iii. Petrous
    2. is saccular
    3. has a parent vessel with diameter 2.5-5.0 mm
  • If target IA has a neck >4 mm, at least 2 of 3 members of an independent expert committee (IEC) have confirmed that coil embolization with optional adjunctive techniques** has a very high likelihood of procedural success (i.e., coil placement and retention)
  • Subject has provided written informed consent using the IRB-approved consent form
  • Subject has the necessary mental capacity to participate and is willing and able to comply with protocol requirements

    • ** Adjunctive techniques include intravascular balloons ["balloon remodeling"], 3D coils, dual catheter techniques.

Exclusion Criteria:

  • Target IA has BOTH neck >4 mm AND size (maximum fundus diameter) >10 mm
  • More than one IA requires treatment in the next 6 months
  • Subarachnoid hemorrhage in the past 60 days
  • Any intracranial hemorrhage in the last 42 days
  • Major surgery in the last 42 days
  • Coils in place in the target IA
  • Unstable neurologic deficit (i.e., any worsening of clinical condition in the last 30 days)
  • Known irreversible bleeding disorder
  • Platelet count < 100 x 103 cells/mm3 or known platelet dysfunction
  • Inability to tolerate, documented evidence of adverse reaction or contraindication to study medications
  • Prior stent placement at target site
  • Contraindication to CT scan AND MRI
  • Known allergy to contrast used in angiography that cannot be medically controlled
  • Known severe allergy to platinum or cobalt/chromium alloys
  • Relative contraindication to angiography (e.g., serum creatinine > 2.5 mg/dL)
  • Woman of child-bearing potential who cannot provide a negative pregnancy test
  • Evidence of active infection at the time of treatment
  • Other known conditions of the heart, blood, brain or intracranial vessels that carry a high risk of neurologic events (e.g., severe heart failure, atrial fibrillation, known carotid stenosis)
  • Current use of cocaine or other illicit substance
  • Any comorbid disease or condition expected to compromise survival or ability to complete follow-up assessments to 180 days
  • Extracranial stenosis greater than 50% in the carotid artery
  • Intracranial stenosis greater than 50% in the treated vessel

Sites / Locations

  • Barrow Neurological Institute
  • SUNY Stony Brook

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Coil embolization

Pipeline

Arm Description

Placement of bare platinum coils into the target aneurysm with balloon remodeling allowed. Stents are not allowed in this arm.

Placement of 1 or more Pipeline Embolization Device(s)(PED) into the parent artery at the target aneurysm.

Outcomes

Primary Outcome Measures

Effectiveness: Proportion of subjects whose target aneurysm shows complete occlusion on angiogram with <=50% stenosis of the parent artery. Safety: Proportion of subjects with ipsilateral major stroke or neurologic death.

Secondary Outcome Measures

Rate of complete target aneurysm occlusion
Incidence of ipsilateral major stroke
Change in modified Rankin scale (MRS)
Incidence of device-related adverse events
Change from baseline in neurologic signs or symptoms related to the target aneurysm

Full Information

First Posted
October 20, 2008
Last Updated
August 5, 2015
Sponsor
Chestnut Medical Technologies
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1. Study Identification

Unique Protocol Identification Number
NCT00777907
Brief Title
Complete Occlusion of Coilable Aneurysms
Acronym
COCOA
Official Title
Complete Occlusion of Coilable Aneurysms
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Completed
Study Start Date
October 2008 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
April 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chestnut Medical Technologies

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To compare the safety and effectiveness of Pipeline Embolization Device to coil embolization for the treatment of coilable wide-necked intracranial aneurysms

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intracranial Aneurysm
Keywords
neurovascular embolization, therapeutic embolization

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Coil embolization
Arm Type
Active Comparator
Arm Description
Placement of bare platinum coils into the target aneurysm with balloon remodeling allowed. Stents are not allowed in this arm.
Arm Title
Pipeline
Arm Type
Experimental
Arm Description
Placement of 1 or more Pipeline Embolization Device(s)(PED) into the parent artery at the target aneurysm.
Intervention Type
Device
Intervention Name(s)
Pipeline Embolization Device (PED)
Other Intervention Name(s)
Pipeline Embolization Device, PED
Intervention Description
1 or more PEDs placed in the parent artery of the affected aneurysm via endovascular approach.
Intervention Type
Device
Intervention Name(s)
Coil embolization
Intervention Description
Placement of bare platinum coils into the target aneurysm with balloon remodeling allowed.
Primary Outcome Measure Information:
Title
Effectiveness: Proportion of subjects whose target aneurysm shows complete occlusion on angiogram with <=50% stenosis of the parent artery. Safety: Proportion of subjects with ipsilateral major stroke or neurologic death.
Time Frame
180 days
Secondary Outcome Measure Information:
Title
Rate of complete target aneurysm occlusion
Time Frame
1, 3 and 5 years
Title
Incidence of ipsilateral major stroke
Time Frame
180 days
Title
Change in modified Rankin scale (MRS)
Time Frame
180 days, 1, 3 and 5 years
Title
Incidence of device-related adverse events
Time Frame
180 days, 1, 3 and 5 years
Title
Change from baseline in neurologic signs or symptoms related to the target aneurysm
Time Frame
180 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 21 to 75 years, inclusive Patient has a single target IA that: is located in the following regions of the internal carotid artery: i. Paraophthalmic (including paraclinoid, ophthalmic and hypophyseal segments) ii. Cavernous iii. Petrous is saccular has a parent vessel with diameter 2.5-5.0 mm If target IA has a neck >4 mm, at least 2 of 3 members of an independent expert committee (IEC) have confirmed that coil embolization with optional adjunctive techniques** has a very high likelihood of procedural success (i.e., coil placement and retention) Subject has provided written informed consent using the IRB-approved consent form Subject has the necessary mental capacity to participate and is willing and able to comply with protocol requirements ** Adjunctive techniques include intravascular balloons ["balloon remodeling"], 3D coils, dual catheter techniques. Exclusion Criteria: Target IA has BOTH neck >4 mm AND size (maximum fundus diameter) >10 mm More than one IA requires treatment in the next 6 months Subarachnoid hemorrhage in the past 60 days Any intracranial hemorrhage in the last 42 days Major surgery in the last 42 days Coils in place in the target IA Unstable neurologic deficit (i.e., any worsening of clinical condition in the last 30 days) Known irreversible bleeding disorder Platelet count < 100 x 103 cells/mm3 or known platelet dysfunction Inability to tolerate, documented evidence of adverse reaction or contraindication to study medications Prior stent placement at target site Contraindication to CT scan AND MRI Known allergy to contrast used in angiography that cannot be medically controlled Known severe allergy to platinum or cobalt/chromium alloys Relative contraindication to angiography (e.g., serum creatinine > 2.5 mg/dL) Woman of child-bearing potential who cannot provide a negative pregnancy test Evidence of active infection at the time of treatment Other known conditions of the heart, blood, brain or intracranial vessels that carry a high risk of neurologic events (e.g., severe heart failure, atrial fibrillation, known carotid stenosis) Current use of cocaine or other illicit substance Any comorbid disease or condition expected to compromise survival or ability to complete follow-up assessments to 180 days Extracranial stenosis greater than 50% in the carotid artery Intracranial stenosis greater than 50% in the treated vessel
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Fiorella, MD, PhD
Organizational Affiliation
Barrow Neurologic Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Barrow Neurological Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
SUNY Stony Brook
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States

12. IPD Sharing Statement

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Complete Occlusion of Coilable Aneurysms

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