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SOLITAIRE™ FR With the Intention For Thrombectomy (SWIFT) Study (SWIFT)

Primary Purpose

Ischemic Stroke

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
SOLITAIRE™ Device
MERCI® Device
Sponsored by
Medtronic Neurovascular Clinical Affairs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ischemic Stroke focused on measuring Ischemic Stroke, SOLITAIRE™ Device, SOLITAIRE™, MERCI® Device, MERCI®, Stroke, Ischemic, Mechanical Thrombectomy, Brain, Brain Clot, Brain Artery Revascularization, Recanalization, Brain Stroke, Clot Retriever, Device, Neurosurgery, Neurovascular Intervention, Interventional Neuroradiology, Brain study, neurovascular clinical trial

Eligibility Criteria

22 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient or patient's legally authorized representative has signed and dated an Informed Consent Form
  • Age22-85
  • Clinical signs consistent with acute ischemic stroke
  • National Institutes of Health Stroke Scale (NIHSS) ≥8and<30
  • Thrombolysis in Myocardial Infarction (TIMI) 0 or TIMI 1 flow in the M1 or M2 of middle cerebral artery, internal carotid artery, basilar or vertebral arteries confirmed by angiography that is accessible to the SOLITAIRETM or MERCI® Device
  • Patient is able to be treated within 8 hours of stroke symptoms onset with minimum of one deployment of the SOLITAIRETM or MERCI® Device.
  • Patient who is ineligible or failed intravenous tissue plasminogen activator (t-PA) therapy given at local institutions or within national practice.
  • Patient is willing to conduct follow-up visits

Exclusion Criteria:

  • NIHSS > 30 or coma
  • Neurological signs that are rapidly improving prior to or at time of treatment
  • Females who are pregnant or lactating
  • Known serious sensitivity to radiographic contrast agents
  • Current participation in another investigation drug or device study
  • Uncontrolled hypertension defined as systolic blood pressure > 185 or diastolic blood pressure > 110 that cannot be controlled except with continuous parenteral antihypertensive medication
  • Use of warfarin anticoagulation with International Normalized Ratio (INR) > 3.0
  • Platelet count < 30,000
  • Glucose < 50 mg/dL
  • Arterial tortuosity that would prevent the device from reaching the target vessel
  • Life expectancy of less than 90 days
  • Computed tomography (CT) or Magnetic Resonance Imaging (MRI) evidence of hemorrhage on presentation
  • CT showing hypodensity or MR showing hyperintensity involving greater than 1/3 of the middle cerebral artery (MCA) territory (or in other territories, >100 cc of tissue) on presentation
  • CT or MRI evidence of mass effect or intracranial tumor (except small meningioma)
  • Angiographic evidence of carotid dissection, complete cervical carotid occlusions, or vasculitis

Sites / Locations

  • Oregon Stroke Center
  • Multicare Health System

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

SOLITAIRE™ Device

MERCI® Device

Arm Description

The SOLITAIRE™ Device (investigational device) is the experimental arm

The MERCI® Device (control device) is commercially available.

Outcomes

Primary Outcome Measures

Recanalization [Thrombolysis in Myocardial Infarction (TIMI) 2 or 3] Without Symptomatic Intracranial Hemorrhage
Successful arterial recanalization of occluded target vessel measured by Thrombolysis in Myocardial Infarction (TIMI) score of 2 or 3 following the use of the SOLITAIRE™ or MERCI® Device without any symptomatic intracranial hemorrhage and rescue therapy within 3 passes. Thrombolysis in Myocardial Infarction (TIMI) score describes the distal flow perfusion and revascularization before and following therapy. TIMI 0 - No perfusion (worst outcome) TIMI 1 - Perfusion past the initial occlusion, but no distal branch filling TIMI 2 - Perfusion with incomplete or slow distal branch filling TIMI 3 - Full perfusion with filling of all distal branches (best outcome)
Study Device-related Serious Adverse Events (SAEs)
Incidence of study device-related Serious Adverse Events (SAEs)
Procedure-related Serious Adverse Events (SAEs)
Incidence of study procedure-related Serious Adverse Events (SAEs)

Secondary Outcome Measures

Time to Initial Recanalization
Time from guide catheter placement to first visualization of Thrombolysis in Myocardial Infarction (TIMI) 2 flow
Good Neurological Outcome at 30 Days
Good neurological outcome, defined as modified Rankin scale (mRS) ≤ 2, or equal to the prestroke mRS if the prestroke mRS was higher than 2, or National Institutes of Health Stroke Scale (NIHSS) score improvement of 10 points or more
Good Neurological Outcome 90 Days
Good neurological outcome, defined as modified Rankin scale (mRS) ≤ 2, or equal to the prestroke mRS if the prestroke mRS was higher than 2, or National Institutes of Health Stroke Scale (NIHSS) score improvement of 10 points or more
Mortality
Rate of Mortality
Symptomatic Intracranial Hemorrhage
Symptomatic hemorrhage within 24 hours of procedure. Symptomatic hemorrhages is defined as any parenchymal hematoma 1 (PH1), parenchymal hematoma 2 (PH2), intraparenchymal hemorrhage remote from the ischemic field (RIH), intraventricular hemorrhage (IVH), and subarachnoid hemorrhage (SAH) associated with a worsening of National Institutes of Health Stroke Scale (NIHSS) ≥ 4 within 24hrs.
Non-fatal Stroke-related Morbidity
Morbidity data is presented in terms of subjects with permanent deficit as a result of one or more adverse events

Full Information

First Posted
December 10, 2009
Last Updated
August 31, 2016
Sponsor
Medtronic Neurovascular Clinical Affairs
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1. Study Identification

Unique Protocol Identification Number
NCT01054560
Brief Title
SOLITAIRE™ FR With the Intention For Thrombectomy (SWIFT) Study
Acronym
SWIFT
Official Title
SOLITAIRE™ FR With the Intention For Thrombectomy (SWIFT) Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
January 2010 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
July 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Neurovascular Clinical Affairs

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to demonstrate substantial equivalence of the SOLITAIRE™ FR Revascularization Device (SOLITAIRE™ Device) with a legally marketed device, MERCI Retrieval System® (MERCI® Device). The study will demonstrate safety and efficacy of the SOLITAIRE™ Device in subjects requiring mechanical thrombectomy diagnosed with acute ischemic stroke.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemic Stroke
Keywords
Ischemic Stroke, SOLITAIRE™ Device, SOLITAIRE™, MERCI® Device, MERCI®, Stroke, Ischemic, Mechanical Thrombectomy, Brain, Brain Clot, Brain Artery Revascularization, Recanalization, Brain Stroke, Clot Retriever, Device, Neurosurgery, Neurovascular Intervention, Interventional Neuroradiology, Brain study, neurovascular clinical trial

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SOLITAIRE™ Device
Arm Type
Experimental
Arm Description
The SOLITAIRE™ Device (investigational device) is the experimental arm
Arm Title
MERCI® Device
Arm Type
Active Comparator
Arm Description
The MERCI® Device (control device) is commercially available.
Intervention Type
Device
Intervention Name(s)
SOLITAIRE™ Device
Intervention Description
The SOLITAIRE™ Device is the experimental device that will be used in the interventional procedure
Intervention Type
Device
Intervention Name(s)
MERCI® Device
Intervention Description
The MERCI® Device is the control device that will be used in the interventional procedure.
Primary Outcome Measure Information:
Title
Recanalization [Thrombolysis in Myocardial Infarction (TIMI) 2 or 3] Without Symptomatic Intracranial Hemorrhage
Description
Successful arterial recanalization of occluded target vessel measured by Thrombolysis in Myocardial Infarction (TIMI) score of 2 or 3 following the use of the SOLITAIRE™ or MERCI® Device without any symptomatic intracranial hemorrhage and rescue therapy within 3 passes. Thrombolysis in Myocardial Infarction (TIMI) score describes the distal flow perfusion and revascularization before and following therapy. TIMI 0 - No perfusion (worst outcome) TIMI 1 - Perfusion past the initial occlusion, but no distal branch filling TIMI 2 - Perfusion with incomplete or slow distal branch filling TIMI 3 - Full perfusion with filling of all distal branches (best outcome)
Time Frame
Immediately post treatment
Title
Study Device-related Serious Adverse Events (SAEs)
Description
Incidence of study device-related Serious Adverse Events (SAEs)
Time Frame
90 Day
Title
Procedure-related Serious Adverse Events (SAEs)
Description
Incidence of study procedure-related Serious Adverse Events (SAEs)
Time Frame
90 Day
Secondary Outcome Measure Information:
Title
Time to Initial Recanalization
Description
Time from guide catheter placement to first visualization of Thrombolysis in Myocardial Infarction (TIMI) 2 flow
Time Frame
post treatment
Title
Good Neurological Outcome at 30 Days
Description
Good neurological outcome, defined as modified Rankin scale (mRS) ≤ 2, or equal to the prestroke mRS if the prestroke mRS was higher than 2, or National Institutes of Health Stroke Scale (NIHSS) score improvement of 10 points or more
Time Frame
30 Days Follow-up
Title
Good Neurological Outcome 90 Days
Description
Good neurological outcome, defined as modified Rankin scale (mRS) ≤ 2, or equal to the prestroke mRS if the prestroke mRS was higher than 2, or National Institutes of Health Stroke Scale (NIHSS) score improvement of 10 points or more
Time Frame
90 Days Follow-up
Title
Mortality
Description
Rate of Mortality
Time Frame
90 Days follow-up
Title
Symptomatic Intracranial Hemorrhage
Description
Symptomatic hemorrhage within 24 hours of procedure. Symptomatic hemorrhages is defined as any parenchymal hematoma 1 (PH1), parenchymal hematoma 2 (PH2), intraparenchymal hemorrhage remote from the ischemic field (RIH), intraventricular hemorrhage (IVH), and subarachnoid hemorrhage (SAH) associated with a worsening of National Institutes of Health Stroke Scale (NIHSS) ≥ 4 within 24hrs.
Time Frame
24 hours
Title
Non-fatal Stroke-related Morbidity
Description
Morbidity data is presented in terms of subjects with permanent deficit as a result of one or more adverse events
Time Frame
90 Day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient or patient's legally authorized representative has signed and dated an Informed Consent Form Age22-85 Clinical signs consistent with acute ischemic stroke National Institutes of Health Stroke Scale (NIHSS) ≥8and<30 Thrombolysis in Myocardial Infarction (TIMI) 0 or TIMI 1 flow in the M1 or M2 of middle cerebral artery, internal carotid artery, basilar or vertebral arteries confirmed by angiography that is accessible to the SOLITAIRETM or MERCI® Device Patient is able to be treated within 8 hours of stroke symptoms onset with minimum of one deployment of the SOLITAIRETM or MERCI® Device. Patient who is ineligible or failed intravenous tissue plasminogen activator (t-PA) therapy given at local institutions or within national practice. Patient is willing to conduct follow-up visits Exclusion Criteria: NIHSS > 30 or coma Neurological signs that are rapidly improving prior to or at time of treatment Females who are pregnant or lactating Known serious sensitivity to radiographic contrast agents Current participation in another investigation drug or device study Uncontrolled hypertension defined as systolic blood pressure > 185 or diastolic blood pressure > 110 that cannot be controlled except with continuous parenteral antihypertensive medication Use of warfarin anticoagulation with International Normalized Ratio (INR) > 3.0 Platelet count < 30,000 Glucose < 50 mg/dL Arterial tortuosity that would prevent the device from reaching the target vessel Life expectancy of less than 90 days Computed tomography (CT) or Magnetic Resonance Imaging (MRI) evidence of hemorrhage on presentation CT showing hypodensity or MR showing hyperintensity involving greater than 1/3 of the middle cerebral artery (MCA) territory (or in other territories, >100 cc of tissue) on presentation CT or MRI evidence of mass effect or intracranial tumor (except small meningioma) Angiographic evidence of carotid dissection, complete cervical carotid occlusions, or vasculitis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey L. Saver, MD
Organizational Affiliation
University of California, Los Angeles
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oregon Stroke Center
City
Portland
State/Province
Oregon
Country
United States
Facility Name
Multicare Health System
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98405
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
31239326
Citation
Raychev R, Saver JL, Jahan R, Nogueira RG, Goyal M, Pereira VM, Gralla J, Levy EI, Yavagal DR, Cognard C, Liebeskind DS. The impact of general anesthesia, baseline ASPECTS, time to treatment, and IV tPA on intracranial hemorrhage after neurothrombectomy: pooled analysis of the SWIFT PRIME, SWIFT, and STAR trials. J Neurointerv Surg. 2020 Jan;12(1):2-6. doi: 10.1136/neurintsurg-2019-014898. Epub 2019 Jun 25. Erratum In: J Neurointerv Surg. 2021 Sep;13(9):e21.
Results Reference
derived
PubMed Identifier
28097310
Citation
Coutinho JM, Liebeskind DS, Slater LA, Nogueira RG, Clark W, Davalos A, Bonafe A, Jahan R, Fischer U, Gralla J, Saver JL, Pereira VM. Combined Intravenous Thrombolysis and Thrombectomy vs Thrombectomy Alone for Acute Ischemic Stroke: A Pooled Analysis of the SWIFT and STAR Studies. JAMA Neurol. 2017 Mar 1;74(3):268-274. doi: 10.1001/jamaneurol.2016.5374.
Results Reference
derived
PubMed Identifier
26658447
Citation
Kim JT, Jahan R, Saver JL; SWIFT Investigators. Impact of Glucose on Outcomes in Patients Treated With Mechanical Thrombectomy: A Post Hoc Analysis of the Solitaire Flow Restoration With the Intention for Thrombectomy Study. Stroke. 2016 Jan;47(1):120-7. doi: 10.1161/STROKEAHA.115.010753. Epub 2015 Dec 10.
Results Reference
derived
PubMed Identifier
25676147
Citation
Sheth SA, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira RG, Clark W, Budzik R, Zaidat OO, Saver JL; SWIFT Trialists. Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial. J Neurointerv Surg. 2016 Apr;8(4):347-52. doi: 10.1136/neurintsurg-2014-011627. Epub 2015 Feb 12.
Results Reference
derived
PubMed Identifier
24876081
Citation
Liebeskind DS, Jahan R, Nogueira RG, Zaidat OO, Saver JL; SWIFT Investigators. Impact of collaterals on successful revascularization in Solitaire FR with the intention for thrombectomy. Stroke. 2014 Jul;45(7):2036-40. doi: 10.1161/STROKEAHA.114.004781. Epub 2014 May 29.
Results Reference
derived
PubMed Identifier
24525954
Citation
Liebeskind DS, Jahan R, Nogueira RG, Jovin TG, Lutsep HL, Saver JL; SWIFT Investigators. Serial Alberta Stroke Program early CT score from baseline to 24 hours in Solitaire Flow Restoration with the Intention for Thrombectomy study: a novel surrogate end point for revascularization in acute stroke. Stroke. 2014 Mar;45(3):723-7. doi: 10.1161/STROKEAHA.113.003914. Epub 2014 Feb 13.
Results Reference
derived
PubMed Identifier
22932715
Citation
Saver JL, Jahan R, Levy EI, Jovin TG, Baxter B, Nogueira RG, Clark W, Budzik R, Zaidat OO; SWIFT Trialists. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet. 2012 Oct 6;380(9849):1241-9. doi: 10.1016/S0140-6736(12)61384-1. Epub 2012 Aug 26.
Results Reference
derived
Links:
URL
http://www.americanheart.org/presenter.jhtml?identifier=3004586
Description
American Heart Association - Stroke
URL
http://www.ev3.net
Description
ev3, Inc.

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SOLITAIRE™ FR With the Intention For Thrombectomy (SWIFT) Study

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