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Safety and Effectiveness of an Intracranial Aneurysm Embolization System for Treating Large or Giant Wide Neck Aneurysms (SCENT)

Primary Purpose

Brain Aneurysm

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Surpass Flow Diverter
Sponsored by
Stryker Neurovascular
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain Aneurysm focused on measuring Large aneurysm, Giant aneurysm, Wide neck aneurysm

Eligibility Criteria

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

Inclusion Criteria:

  • Age 19 to 80 years
  • Subject or legal representative is willing and able to give informed consent
  • Subject has a single targeted intracranial aneurysm
  • Subject agrees to return to the treating Investigator for all scheduled follow up visits and is capable of returning to the hospital for follow up

Exclusion Criteria:

  • Known allergy or contraindication to aspirin, clopidogrel/Plavix, heparin, local or general anesthesia
  • Known history of life threatening allergy to contrast dye
  • Known allergy to nickel, chromium cobalt, tungsten or platinum
  • Subject has documented resistance to clopidogrel/Plavix
  • Major surgery within previous 30 days or planned in the next 120 days after enrollment date
  • Previous intracranial implant associated with the symptomatic distribution within the past 12 weeks prior to treatment date
  • Stenting, angioplasty, or endarterectomy of an extracranial (carotid or vertebral artery) or intracranial artery within 30 days prior to treatment date
  • Any previous stenting of parent artery at or proximal to the aneurysm where it would interfere with the placement and proper apposition of the device
  • Any previous coiling where it would interfere with the placement and proper apposition of the device
  • Platelet count less than 100,000 cells/mm3 or known platelet dysfunction
  • More than one intracranial aneurysm (IA) that requires treatment within 12 months
  • Asymptomatic extradural aneurysms requiring treatment
  • Contraindication to CT scan or MRI
  • Severe neurological deficit that renders the subject incapable of living independently
  • Unstable neurological deficit (i.e., worsening of clinical condition in the last 30 days)
  • Evidence of active infection at the time of treatment
  • Dementia or psychiatric problem that prevents the patient from completing required follow up
  • Co-morbid conditions that may limit survival to less than 24 months
  • Serum creatinine greater or equal to 2.5 mg/dL
  • Female subjects who are pregnant or planning to become pregnant within the study period
  • Subject with anatomy not appropriate for endovascular treatment due to severe intracranial vessel tortuosity or stenosis
  • Extra-cranial stenosis or parent vessel with stenosis greater than 50% in the area proximal to the aneurysm
  • Other known serious concurrent medical conditions
  • History of intracranial vasospasm not responsive to medical therapy
  • Subject with an intracranial mass, or is undergoing radiation therapy for carcinoma or sarcoma of the head or neck region
  • Subject has a history of bleeding diathesis or coagulopathy, international normalized ratio (INR) greater than 1.5, or will refuse blood transfusions
  • Subject had a subarachnoid hemorrhage within 30 days prior to the enrollment date
  • Subject has a non-treated arteriovenous malformation (AVM) in the territory of the target aneurysm
  • Inability to understand the study or a history of non-compliance with medical advice
  • Current use of illicit substance
  • Enrollment in another trial involving an investigational product
  • Subject has a need for long-term use of anticoagulants (i.e., Warfarin, Dabigatran)

Sites / Locations

  • University of California
  • Santa Barbara Cottage Hospital
  • University of Florida
  • Lyerly Neurosurgery/Baptist Health System
  • Mayo Clinic - Florida
  • Baptist Hospital of Miami
  • Tampa General Hospital
  • Rush University Medical Center
  • The University of Kansas Medical Center
  • Johns Hopkins University
  • University of Massachusetts Medical School
  • Mayo Clinic - Minnesota
  • University at Buffalo
  • Columbia University
  • Cleveland Clinic
  • Oregon Health and Science University
  • Thomas Jefferson University
  • Medical University of South Carolina
  • Fort Sanders Medical Center
  • Vanderbilt University Medical Center
  • University of Texas - Southwestern
  • Baylor College of Medicine
  • University of Utah
  • University of Virginia
  • The Medical College of Wisconsin
  • UMC St Radboud

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Surpass Flow Diverter

Arm Description

The objective of this study is to determine the safety and effectiveness of the Surpass Flow Diverter (Surpass System) in the endovascular treatment of large or giant wide-necked intracranial aneurysms in the internal carotid artery up to the terminus.

Outcomes

Primary Outcome Measures

mITT Primary Effectiveness Endpoint. Based on Subjects With 100% Occlusion of the Aneurysm Without Clinically Significant Stenosis of the Parent Artery, and Without Any Subsequent Treatment of the Target Aneurysm at the 12 Month Follow up Visit.
Percent of subjects with 100% occlusion of the aneurysm without clinically significant stenosis (defined as less than or equal to 50% stenosis) of the parent artery based on core lab evaluation of the 12 month follow up angiogram and without any subsequent treatment of the target aneurysm at the 12 month follow up visit.
mITT Primary Safety Endpoint. Based on Subjects Experiencing Neurologic Death or Major Ipsilateral Stroke Through 12 Month Follow-up.
Subjects experiencing neurologic death or major ipsilateral stroke through 12 months.

Secondary Outcome Measures

Raymond-Roy Score Per Core Lab Assessment Based on Device Apposition at 12 Months Post-Procedure
The Raymond-Roy intracranial aneurysm occlusion classification was used to assess the rate of aneurysm occlusion at the time of primary endpoint assessment (12 months). Occlusion rates were reported as Class I: complete obliteration (best); Class II: residual neck; Class III: residual aneurysm (worse).

Full Information

First Posted
October 24, 2012
Last Updated
December 15, 2022
Sponsor
Stryker Neurovascular
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1. Study Identification

Unique Protocol Identification Number
NCT01716117
Brief Title
Safety and Effectiveness of an Intracranial Aneurysm Embolization System for Treating Large or Giant Wide Neck Aneurysms
Acronym
SCENT
Official Title
The Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large or Giant Wide Neck Aneurysms (SCENT Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
October 25, 2012 (Actual)
Primary Completion Date
December 11, 2016 (Actual)
Study Completion Date
July 7, 2022 (Actual)

3. Sponsor/Collaborators

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

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
This clinical research study is designed to determine safety and effectiveness of the Surpass Flow Diverter (Surpass System), an investigational device developed to treat wide-neck, large or giant intracranial aneurysms. An intracranial aneurysm is a bulge in the wall of a blood vessel in the brain. The bulge is caused by a weakening of the vessel wall. If left untreated, the bulge may continue to grow larger and ultimately the vessel may break open (rupture), resulting in serious bleeding into or around the brain. The information collected from this study will be used to evaluate how well patients do when treated with the Surpass System both immediately after treatment of an aneurysm and over a long period of time (5 years).
Detailed Description
The objective of this study is to determine safety and effectiveness of the Surpass Flow Diverter (Surpass System) in the endovascular treatment of large or giant wide-necked intracranial aneurysms in the internal carotid artery up to the terminus. The Surpass Flow Diverter is an intracranial implant designed to be placed in a parent artery so as to divert blood flow away from an aneurysm. Use of the Surpass System may be associated with a decrease in neurological death or ipsilateral stroke in patients with large or giant wide-neck aneurysms. In a given patient, the Surpass System will be deemed effective if treatment results in complete occlusion of their aneurysm without clinically significant stenosis of the parent artery, or requires retreatment of the aneurysm through 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Aneurysm
Keywords
Large aneurysm, Giant aneurysm, Wide neck aneurysm

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
The SCENT Trial is a multi-center, prospective, non-randomized trial.
Masking
None (Open Label)
Allocation
N/A
Enrollment
213 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Surpass Flow Diverter
Arm Type
Experimental
Arm Description
The objective of this study is to determine the safety and effectiveness of the Surpass Flow Diverter (Surpass System) in the endovascular treatment of large or giant wide-necked intracranial aneurysms in the internal carotid artery up to the terminus.
Intervention Type
Device
Intervention Name(s)
Surpass Flow Diverter
Other Intervention Name(s)
Flow diverter, Endovascular aneurysm treatment
Intervention Description
Treatment of an intracranial aneurysm involves the placement of a specially designed metallic mesh tube in a vessel in the brain where an aneurysm is located. The device looks like a fishnet sock with both ends open. Each device is delivered through a small catheter (a long, flexible tube). The catheter containing the device is inserted and advanced into a vessel in the brain. The device is then placed in the brain vessel by releasing it from the catheter. Once the device is placed inside the brain vessel, it is intended to reinforce the area of the vessel that is weakened and bulging (the aneurysm), and to cause blood to flow down the vessel and away from the aneurysm while allowing blood in the aneurysm to clot. This procedure is called an endovascular aneurysm treatment because the device is delivered through the blood vessels.
Primary Outcome Measure Information:
Title
mITT Primary Effectiveness Endpoint. Based on Subjects With 100% Occlusion of the Aneurysm Without Clinically Significant Stenosis of the Parent Artery, and Without Any Subsequent Treatment of the Target Aneurysm at the 12 Month Follow up Visit.
Description
Percent of subjects with 100% occlusion of the aneurysm without clinically significant stenosis (defined as less than or equal to 50% stenosis) of the parent artery based on core lab evaluation of the 12 month follow up angiogram and without any subsequent treatment of the target aneurysm at the 12 month follow up visit.
Time Frame
12 months
Title
mITT Primary Safety Endpoint. Based on Subjects Experiencing Neurologic Death or Major Ipsilateral Stroke Through 12 Month Follow-up.
Description
Subjects experiencing neurologic death or major ipsilateral stroke through 12 months.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Raymond-Roy Score Per Core Lab Assessment Based on Device Apposition at 12 Months Post-Procedure
Description
The Raymond-Roy intracranial aneurysm occlusion classification was used to assess the rate of aneurysm occlusion at the time of primary endpoint assessment (12 months). Occlusion rates were reported as Class I: complete obliteration (best); Class II: residual neck; Class III: residual aneurysm (worse).
Time Frame
12 months
Other Pre-specified Outcome Measures:
Title
Clinical Events Committee (CEC) Adjudicated Rate of Minor Strokes Through 12 Month Follow-Up
Description
Patients with minor strokes through 12 months
Time Frame
12 Months
Title
Subgroup Analysis of Primary Effectiveness Endpoint Based on Subject Age ≥ 65 Years Versus < 65 Years in mITT Population
Description
Primary effectiveness by age group
Time Frame
12 Months
Title
CEC Adjudicated Primary Effectiveness Endpoint Outcomes for Giant and Non-Giant (Large) Intracranial Aneurysms Through 12 Month Follow-Up - mITT Population
Description
Primary effectiveness by intracranial aneurysm size
Time Frame
12 Months
Title
Number of Surpass Streamline Flow Diverters Implanted Per Subject in SCENT Trial - mITT and Roll-In Populations
Description
Number of devices implanted in subjects by study population
Time Frame
12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 19 to 80 years Subject or legal representative is willing and able to give informed consent Subject has a single targeted intracranial aneurysm Subject agrees to return to the treating Investigator for all scheduled follow up visits and is capable of returning to the hospital for follow up Exclusion Criteria: Known allergy or contraindication to aspirin, clopidogrel/Plavix, heparin, local or general anesthesia Known history of life threatening allergy to contrast dye Known allergy to nickel, chromium cobalt, tungsten or platinum Subject has documented resistance to clopidogrel/Plavix Major surgery within previous 30 days or planned in the next 120 days after enrollment date Previous intracranial implant associated with the symptomatic distribution within the past 12 weeks prior to treatment date Stenting, angioplasty, or endarterectomy of an extracranial (carotid or vertebral artery) or intracranial artery within 30 days prior to treatment date Any previous stenting of parent artery at or proximal to the aneurysm where it would interfere with the placement and proper apposition of the device Any previous coiling where it would interfere with the placement and proper apposition of the device Platelet count less than 100,000 cells/mm3 or known platelet dysfunction More than one intracranial aneurysm (IA) that requires treatment within 12 months Asymptomatic extradural aneurysms requiring treatment Contraindication to CT scan or MRI Severe neurological deficit that renders the subject incapable of living independently Unstable neurological deficit (i.e., worsening of clinical condition in the last 30 days) Evidence of active infection at the time of treatment Dementia or psychiatric problem that prevents the patient from completing required follow up Co-morbid conditions that may limit survival to less than 24 months Serum creatinine greater or equal to 2.5 mg/dL Female subjects who are pregnant or planning to become pregnant within the study period Subject with anatomy not appropriate for endovascular treatment due to severe intracranial vessel tortuosity or stenosis Extra-cranial stenosis or parent vessel with stenosis greater than 50% in the area proximal to the aneurysm Other known serious concurrent medical conditions History of intracranial vasospasm not responsive to medical therapy Subject with an intracranial mass, or is undergoing radiation therapy for carcinoma or sarcoma of the head or neck region Subject has a history of bleeding diathesis or coagulopathy, international normalized ratio (INR) greater than 1.5, or will refuse blood transfusions Subject had a subarachnoid hemorrhage within 30 days prior to the enrollment date Subject has a non-treated arteriovenous malformation (AVM) in the territory of the target aneurysm Inability to understand the study or a history of non-compliance with medical advice Current use of illicit substance Enrollment in another trial involving an investigational product Subject has a need for long-term use of anticoagulants (i.e., Warfarin, Dabigatran)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ricardo A Hanel, MD, PhD
Organizational Affiliation
Lyerly Baptist Medical Center, Jacksonville, Florida
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Philip M Meyers, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
Santa Barbara Cottage Hospital
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32611
Country
United States
Facility Name
Lyerly Neurosurgery/Baptist Health System
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Mayo Clinic - Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Baptist Hospital of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
The University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
University of Massachusetts Medical School
City
Worcester
State/Province
Massachusetts
ZIP/Postal Code
01655
Country
United States
Facility Name
Mayo Clinic - Minnesota
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55902
Country
United States
Facility Name
University at Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14203
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
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 Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37916
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
University of Texas - Southwestern
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
The Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
UMC St Radboud
City
Nijmegen
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There is no plan to make IPD information available to other researchers. Blinded study data by mITT and Roll-in cohorts may be made available to SCENT researchers post publication of the primary study results.
Citations:
PubMed Identifier
36375835
Citation
Hanel RA, Cortez GM, Coon AL, Kan P, Taussky P, Wakhloo AK, Welch BG, Dogan A, Bain M, De Vries J, Ebersole K, Meyers PM; SCENT Investigator Group. Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large or Giant Wide-Neck Aneurysms - SCENT: 3-year outcomes. J Neurointerv Surg. 2022 Nov 14:jnis-2022-019512. doi: 10.1136/jnis-2022-019512. Online ahead of print.
Results Reference
derived
PubMed Identifier
35551072
Citation
Kan P, Mohanty A, Meyers PM, Coon AL, Wakhloo AK, Marosfoi M, Bain M, de Vries J, Ebersole K, Lanzino G, Taussky P, Hanel RA. Treatment of large and giant posterior communicating artery aneurysms with the Surpass streamline flow diverter: results from the SCENT trial. J Neurointerv Surg. 2023 Jul;15(7):679-683. doi: 10.1136/neurintsurg-2021-018189. Epub 2022 May 12.
Results Reference
derived
PubMed Identifier
31084335
Citation
Meyers PM, Coon AL, Kan PT, Wakhloo AK, Hanel RA. SCENT Trial. Stroke. 2019 Jun;50(6):1473-1479. doi: 10.1161/STROKEAHA.118.024135. Epub 2019 May 14.
Results Reference
derived
PubMed Identifier
25987590
Citation
Colby GP, Lin LM, Caplan JM, Jiang B, Michniewicz B, Huang J, Tamargo RJ, Coon AL. Flow diversion of large internal carotid artery aneurysms with the surpass device: impressions and technical nuance from the initial North American experience. J Neurointerv Surg. 2016 Mar;8(3):279-86. doi: 10.1136/neurintsurg-2015-011769. Epub 2015 May 18.
Results Reference
derived

Learn more about this trial

Safety and Effectiveness of an Intracranial Aneurysm Embolization System for Treating Large or Giant Wide Neck Aneurysms

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