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MAPS Trial: Matrix And Platinum Science (MAPS)

Primary Purpose

Intracranial Aneurysms

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Matrix 2® coils for endovascular aneurysm occlusion
GDC® coils for endovascular aneurysm occlusion
Sponsored by
Stryker Neurovascular
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intracranial Aneurysms focused on measuring Intracranial saccular aneurysms, Endovascular coiling therapy, Retreatment, Raymond scale, Matrix, GDC, Guglielmi Detachable Coil

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient is between 18 and 80 years of age (inclusive).
  2. Patient has a documented untreated intracranial saccular aneurysm 4-20 mm diameter angiographic lumen, ruptured or unruptured, suitable for embolization with coils.
  3. Both GDC® Coils and Matrix 2® Coils (Every attempt should be made to treat with as much randomized coil type as possible to achieve optimal occlusion.) are treatment options (all shapes allowed with exception of GDC VortX Coil).
  4. Target aneurysm can be adequately coiled at index procedure (NO staged coiling procedures). If a Neuroform stent is to be placed during a separate preliminary procedure, then screening and enrollment for the coiling procedure must take place after the stenting procedure is completed.
  5. Target aneurysm morphology allows for adequate retention of coils within the aneurysmal sac without occlusion of the parent artery, as determined by the treating physician.
  6. Patient (or patient's legally authorized representative for centers in the United States) has provided written informed consent.
  7. Patient is willing and able to comply with protocol follow-up requirements.

Exclusion Criteria:

  1. Patient is < 18 or > 80 years old.
  2. Target aneurysm is not saccular in nature (mycotic, fusiform, dissecting).
  3. Target aneurysm is > 20 mm maximum luminal dimension, < 4 mm maximum luminal dimension.
  4. Target aneurysm has been previously treated by surgery or endovascular therapy.
  5. Target aneurysm is in the physician's estimation unlikely to be successfully treated by endovascular techniques.
  6. Patient presents as Hunt and Hess grade IV or V for a ruptured aneurysm.
  7. Patient presents with Modified Rankin Score 4 or 5 at baseline.
  8. Patient is concurrently enrolled in another investigational drug or device study unless permission is granted by the sponsor.
  9. Patient has known hypersensitivity to Polyglycolic Polylactic Acid (PGLA), platinum, nickel, stainless steel or structurally related compounds found in Matrix 2® Coils and/or GDC® Coils.
  10. Patients who have had or could have a severe reaction to contrast agents that cannot be adequately pre-medicated prior to the coiling procedure.
  11. Patients who are unable to complete scheduled follow up assessments at the enrolling center due to limited life expectancy (< 12 months), comorbidities or geographical considerations.
  12. Planned use of adjunctive therapy stents except Neuroform is not allowed.
  13. Patients with Moya-Moya disease, AVMs, AV fistula, intracranial tumors, intracranial hematoma (unrelated to target aneurysm), significant atherosclerotic stenosis, tortuousity or other conditions preventing access to the target aneurysm.
  14. Patients with multiple aneurysms.
  15. Target aneurysm with significant thrombosis that may increase the likelihood of recanalization at the discretion of the investigator.
  16. Female patient has a positive pregnancy assessment at baseline.

Sites / Locations

  • St. Joseph's Hospital Barrow Neurological Institute
  • Tucson Medical Center
  • Yale-New Haven Hospital
  • Rush Presbyterian
  • The Universtiy of Iowa
  • University of Maryland
  • Massachusetts General Hospital
  • University of Massachusetts Worcester
  • Providence Detroit
  • St. Joseph's Hospital
  • Saint Luke's Hospital of Kansas City
  • Barnes Jewish Mallinckrodt Institute of Radiology
  • Sunrise Hospital and Medical Center
  • University of New Mexico Department of Neurosurgery
  • Stony Brook Medical Center
  • Carolina Neurosurgery & Spine Associates, PA
  • Cleveland Clinic Foundation
  • Mercy Health Center
  • OHSU
  • Medical University of South Carolina
  • Fort Sanders Regional Medical Center
  • University of Texas Southwestern Medical Center
  • Methodist Hospital
  • University of Washington Harborview Medical Center
  • Sacred Heart Providence
  • University of Wisconsin Hospital and Center
  • Royal Melbourne Hospital
  • Montreal Neurological Institute and Hospital
  • Xuan Wu Hospital
  • CHU Montpelier
  • Klinikum Augsburg
  • Universitaetsklinikum Freiburg
  • Asklepios Klinik Altona
  • Universitaetsklinikum des Saarlandes
  • Instituto Nacional de Neurologia e Neurocirurgia
  • Rikshospitalet University Hospital
  • Hospital General
  • Hospital Clinico Y provincial
  • Clinica Ntra Sra Del Rosario Hospital Ruber Internacional
  • Hospital Donostia
  • Istanbul University Cerrahpaşa Tıp Fakültesi
  • The Walton Centre
  • Newcastle General Hospital Department of Neuroradiology

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Matrix 2® Coils

GDC® Coils

Arm Description

Matrix 2® Coils for endovascular aneurysm occlusion

GDC® Coils for endovascular aneurysm occlusion

Outcomes

Primary Outcome Measures

Target Aneurysm Recurrence (TAR) Defined as Clinically Relevant Recurrence Resulting in Target Aneurysm Reintervention, Rupture/Re-rupture and/or Death From an Unknown Cause.

Secondary Outcome Measures

Angiographic Assessments
Number of participants with angiographic assessment of "complete obliteration".
Neurological Assessments
The changes in modified Rankin Scores from pre-procedure to 12-month were measured. the outcome below reflects "same or better".
Technical Procedure Success
Target Aneurysm Recurrence
Target Aneurysm Recurrence
Target Aneurysm Recurrence

Full Information

First Posted
November 6, 2006
Last Updated
January 19, 2016
Sponsor
Stryker Neurovascular
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1. Study Identification

Unique Protocol Identification Number
NCT00396981
Brief Title
MAPS Trial: Matrix And Platinum Science
Acronym
MAPS
Official Title
A Prospective, Randomized, Multicenter Trial Investigating Matrix 2® and GDC® Detachable Coils for the Treatment of Intracranial Saccular Aneurysms
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
March 2007 (undefined)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stryker Neurovascular

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Primary Objectives: To establish Target Aneurysm Recurrence (TAR) rates for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms. TAR is defined as clinically relevant recurrence resulting in: target aneurysm reintervention, rupture/re-rupture and/or death from an unknown cause. To correlate defined angiographic endpoints with TAR rates and assess their predictive value, thereby providing a framework to establish clinically relevant endpoints for future studies. Secondary Objectives: To evaluate device characteristics, incidence and severity of device-related adverse events, including death, neurological deterioration and changes in functional abilities. To establish angiographic recurrence rates for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms. To explore an experimental, quantitative and volumetric endpoint and correlate these with existing qualitative assessments.
Detailed Description
The endovascular treatment of intracranial aneurysms has become an accepted alternative to surgical repair given the many recent advances with neurointerventional devices and procedures. The introduction of GDC coils in 1993 provided physicians and their patients a less invasive treatment option. Additionally, the results of two large international trials, ISAT and ISUIA, have shown the benefits of endovascular treatment over surgery for treatment of specific types of aneurysms. One limitation of endovascular coil embolization is aneurysm recurrence or recanalization which is not infrequently observed angiographically at follow up. Aneurysm recanalization may be a result of aneurysm morphology, anatomic location and flow orientation, aneurysm regrowth or the degree of coil compaction. Despite the widespread adoption of endovascular aneurysm coiling, there remains much to be learned about the efficacy and optimization of this treatment modality. The goal of endovascular embolization of intracranial aneurysms is to prevent rupture or re-rupture. Fortunately, the incidence of aneurysm rupture following coil embolization is very low. Follow-up angiographic analysis to evaluate the occlusion and stability of the treated aneurysm provides a surrogate endpoint against which to weigh the likelihood of rupture/re-rupture. However, angiographic interpretation is subjective, operator dependent and can be influenced by multiple confounding variables. The MAPS trial will examine Target Aneurysm Recurrence Rates: clinically relevant recurrence rates resulting in target aneurysm reintervention, rupture/re-rupture and/or death from an unknown cause for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms. The trial will compare TAR rates to recurrences measured by angiographic analysis and assess the utility of angiographic analysis for predicting clinically relevant recurrences.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intracranial Aneurysms
Keywords
Intracranial saccular aneurysms, Endovascular coiling therapy, Retreatment, Raymond scale, Matrix, GDC, Guglielmi Detachable Coil

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
626 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Matrix 2® Coils
Arm Type
Active Comparator
Arm Description
Matrix 2® Coils for endovascular aneurysm occlusion
Arm Title
GDC® Coils
Arm Type
Active Comparator
Arm Description
GDC® Coils for endovascular aneurysm occlusion
Intervention Type
Device
Intervention Name(s)
Matrix 2® coils for endovascular aneurysm occlusion
Intervention Description
endovascular aneurysm occlusion coil
Intervention Type
Device
Intervention Name(s)
GDC® coils for endovascular aneurysm occlusion
Intervention Description
endovascular aneurysm occlusion coil
Primary Outcome Measure Information:
Title
Target Aneurysm Recurrence (TAR) Defined as Clinically Relevant Recurrence Resulting in Target Aneurysm Reintervention, Rupture/Re-rupture and/or Death From an Unknown Cause.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Angiographic Assessments
Description
Number of participants with angiographic assessment of "complete obliteration".
Time Frame
Reintervention or 12 months
Title
Neurological Assessments
Description
The changes in modified Rankin Scores from pre-procedure to 12-month were measured. the outcome below reflects "same or better".
Time Frame
12 months
Title
Technical Procedure Success
Time Frame
Post-procedure
Title
Target Aneurysm Recurrence
Time Frame
2 years
Title
Target Aneurysm Recurrence
Time Frame
3 years
Title
Target Aneurysm Recurrence
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is between 18 and 80 years of age (inclusive). Patient has a documented untreated intracranial saccular aneurysm 4-20 mm diameter angiographic lumen, ruptured or unruptured, suitable for embolization with coils. Both GDC® Coils and Matrix 2® Coils (Every attempt should be made to treat with as much randomized coil type as possible to achieve optimal occlusion.) are treatment options (all shapes allowed with exception of GDC VortX Coil). Target aneurysm can be adequately coiled at index procedure (NO staged coiling procedures). If a Neuroform stent is to be placed during a separate preliminary procedure, then screening and enrollment for the coiling procedure must take place after the stenting procedure is completed. Target aneurysm morphology allows for adequate retention of coils within the aneurysmal sac without occlusion of the parent artery, as determined by the treating physician. Patient (or patient's legally authorized representative for centers in the United States) has provided written informed consent. Patient is willing and able to comply with protocol follow-up requirements. Exclusion Criteria: Patient is < 18 or > 80 years old. Target aneurysm is not saccular in nature (mycotic, fusiform, dissecting). Target aneurysm is > 20 mm maximum luminal dimension, < 4 mm maximum luminal dimension. Target aneurysm has been previously treated by surgery or endovascular therapy. Target aneurysm is in the physician's estimation unlikely to be successfully treated by endovascular techniques. Patient presents as Hunt and Hess grade IV or V for a ruptured aneurysm. Patient presents with Modified Rankin Score 4 or 5 at baseline. Patient is concurrently enrolled in another investigational drug or device study unless permission is granted by the sponsor. Patient has known hypersensitivity to Polyglycolic Polylactic Acid (PGLA), platinum, nickel, stainless steel or structurally related compounds found in Matrix 2® Coils and/or GDC® Coils. Patients who have had or could have a severe reaction to contrast agents that cannot be adequately pre-medicated prior to the coiling procedure. Patients who are unable to complete scheduled follow up assessments at the enrolling center due to limited life expectancy (< 12 months), comorbidities or geographical considerations. Planned use of adjunctive therapy stents except Neuroform is not allowed. Patients with Moya-Moya disease, AVMs, AV fistula, intracranial tumors, intracranial hematoma (unrelated to target aneurysm), significant atherosclerotic stenosis, tortuousity or other conditions preventing access to the target aneurysm. Patients with multiple aneurysms. Target aneurysm with significant thrombosis that may increase the likelihood of recanalization at the discretion of the investigator. Female patient has a positive pregnancy assessment at baseline.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
S. Claiborne Johnston, MD, PhD
Organizational Affiliation
University of California, San Francisco, CA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Cameron McDougall, MD
Organizational Affiliation
Barrow Neurological Institute, Phoenix, AZ
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Anil Gholkar, MD
Organizational Affiliation
Newcastle Upon Tyne Hospitals, NHS Trust, UK
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Joseph's Hospital Barrow Neurological Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
Tucson Medical Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
Yale-New Haven Hospital
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Rush Presbyterian
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60640
Country
United States
Facility Name
The Universtiy of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
University of Maryland
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
University of Massachusetts Worcester
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
Providence Detroit
City
Southfield
State/Province
Michigan
ZIP/Postal Code
48075
Country
United States
Facility Name
St. Joseph's Hospital
City
St. Paul
State/Province
Minnesota
ZIP/Postal Code
55104
Country
United States
Facility Name
Saint Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Barnes Jewish Mallinckrodt Institute of Radiology
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Sunrise Hospital and Medical Center
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89109
Country
United States
Facility Name
University of New Mexico Department of Neurosurgery
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87131
Country
United States
Facility Name
Stony Brook Medical Center
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
Carolina Neurosurgery & Spine Associates, PA
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Mercy Health Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
Facility Name
OHSU
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Fort Sanders Regional Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37916
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-8896
Country
United States
Facility Name
Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Washington Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Sacred Heart Providence
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States
Facility Name
University of Wisconsin Hospital and Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792
Country
United States
Facility Name
Royal Melbourne Hospital
City
Parkville
ZIP/Postal Code
3052
Country
Australia
Facility Name
Montreal Neurological Institute and Hospital
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3A 2B4
Country
Canada
Facility Name
Xuan Wu Hospital
City
Beijing
Country
China
Facility Name
CHU Montpelier
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Klinikum Augsburg
City
Augsburg
ZIP/Postal Code
86156
Country
Germany
Facility Name
Universitaetsklinikum Freiburg
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
Asklepios Klinik Altona
City
Hamburg
ZIP/Postal Code
22763
Country
Germany
Facility Name
Universitaetsklinikum des Saarlandes
City
Homburg/Saar
ZIP/Postal Code
66421
Country
Germany
Facility Name
Instituto Nacional de Neurologia e Neurocirurgia
City
Mexico City
ZIP/Postal Code
14269
Country
Mexico
Facility Name
Rikshospitalet University Hospital
City
Oslo
ZIP/Postal Code
0027
Country
Norway
Facility Name
Hospital General
City
Alicante
Country
Spain
Facility Name
Hospital Clinico Y provincial
City
Barcelona
Country
Spain
Facility Name
Clinica Ntra Sra Del Rosario Hospital Ruber Internacional
City
Madrid
ZIP/Postal Code
28056
Country
Spain
Facility Name
Hospital Donostia
City
San Sebastian
Country
Spain
Facility Name
Istanbul University Cerrahpaşa Tıp Fakültesi
City
Kocamustafapasa
State/Province
Istanbul
ZIP/Postal Code
34300
Country
Turkey
Facility Name
The Walton Centre
City
Fazakerley
State/Province
Liverpool
ZIP/Postal Code
L9 7LJ
Country
United Kingdom
Facility Name
Newcastle General Hospital Department of Neuroradiology
City
Tyne and Wear
ZIP/Postal Code
NE4 6BE
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
24481333
Citation
McDougall CG, Johnston SC, Gholkar A, Barnwell SL, Vazquez Suarez JC, Masso Romero J, Chaloupka JC, Bonafe A, Wakhloo AK, Tampieri D, Dowd CF, Fox AJ, Imm SJ, Carroll K, Turk AS; MAPS Investigators. Bioactive versus bare platinum coils in the treatment of intracranial aneurysms: the MAPS (Matrix and Platinum Science) trial. AJNR Am J Neuroradiol. 2014 May;35(5):935-42. doi: 10.3174/ajnr.A3857. Epub 2014 Jan 30.
Results Reference
derived
PubMed Identifier
24184523
Citation
Hetts SW, Turk A, English JD, Dowd CF, Mocco J, Prestigiacomo C, Nesbit G, Ge SG, Jin JN, Carroll K, Murayama Y, Gholkar A, Barnwell S, Lopes D, Johnston SC, McDougall C; Matrix and Platinum Science Trial Investigators. Stent-assisted coiling versus coiling alone in unruptured intracranial aneurysms in the matrix and platinum science trial: safety, efficacy, and mid-term outcomes. AJNR Am J Neuroradiol. 2014 Apr;35(4):698-705. doi: 10.3174/ajnr.A3755. Epub 2013 Nov 1.
Results Reference
derived

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MAPS Trial: Matrix And Platinum Science

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