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No safety issues. Low enrollment secondary to negative stroke studies 2013
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| Name | Class |
|---|---|
| University of California, Los Angeles | OTHER |
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Stroke is the second leading cause of death and the leading cause of adult disability worldwide. This investigation will address the safety and feasibility of directed, intra-arterial Magnesium measurement and therapy, through endovascular access, in acute stroke patients. The proposal represents the first study to directly quantify levels of a systemically administered neuroprotectant in the region of cerebral ischemia. It also establishes a novel endovascular platform for direct delivery of neuroprotective agents to ischemic cerebral tissue distal to an occlusive thrombus. This research seeks to improve patient care by establishing a novel delivery mechanism for the rescue of threatened brain parenchyma that can be administered rapidly following acute stroke. If successful, this selective distribution will allow delivery to "at risk" tissue in a rapid manner. Salvage of viable, but threatened, penumbral tissue could afford stroke patients an increased probability of favorable long term outcome. The investigators hypothesize that endovascular, intra-arterial, Magnesium administration will deliver high concentration of this neuroprotective agent to otherwise inaccessible cerebral territories, while limiting systemic concentrations. The proposed investigation will evaluate the safety and feasibility of this novel treatment technique
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regional Intra-arterial Magnesium 0.75g | Experimental | Regional Intra-arterial magnesium only 0.75 mg Magnesium Sulfate (50% Total Dose): 5 patients |
|
| Regional Intra-arterial magnesium 1.5g | Experimental | Regional Intra-arterial magnesium Sulfate Only 1.5g (100% TD): 5 patients |
|
| Regional/ Distal (75/25%) Magnesium 1.5g | Experimental | Regional/ Distal intra-arterial magnesium (75% TD regional- 1.125g / 25% distal-0.375g): 5 patients |
|
| Regional/ Distal (50/50%) Magnesium 1.5g | Experimental | Regional/ Distal intra-arterial magnesium (50% TD regional- 0.75g/ 50% distal-0.75g): 5 patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magnesium Sulfate | Drug | Intra-arterial |
|
| Measure | Description | Time Frame |
|---|---|---|
| Magnesium Concentration in Region of Cerebral Ischemia | Peripheral Magnesium Levels, meq/L will be obtained through the femoral sheath at the beginning (baseline) and end (post-treatment) of each case. These will be averaged to obtain a femoral Magnesium level. Magnesium levels distal to the occlusion will be measured at the first pass of the clot retrieving device. | Mg level: 1) Peripheral: Baseline and post-treatment (averaged); 2) Distal: after first pass of the clot retriever |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Procedure Related Serious Adverse Event | Periprocedural clinical, radiographic and laboratory data will be collected and analyzed to detect Mg related adverse events. Outcome will be assessed perioperatively and at 24 hours, 30 days (+/- 10 days) and 90 days (+/- 15 days) | intraprocedure, postoperative day 1, 1 month, 3 month |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| William J Mack, MD | University of Southern California | Principal Investigator |
| Jeffrey Saver, MD | University of California, Los Angeles | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University California Los Angeles: Ronald Reagan and Santa Monica Hospitals | Los Angeles | California | 900094 | United States | ||
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| ID | Title | Description |
|---|---|---|
| FG000 | Regional Intra-arterial Magnesium 0.75g | Regional only 0.75 mg Magnesium Sulfate (50% Total Dose): 5 patients Magnesium Sulfate: Intra-arterial |
| FG001 | Regional Intra-arterial Magnesium 1.5g | Regional Intra-arterial magnesium Sulfate Only 1.5g (100% TD): 5 patients Magnesium Sulfate: Intra-arterial |
| FG002 | Regional/ Distal (75/25%) Magnesium 1.5g | Regional/ Distal(75% TD regional- 1.125g / 25% distal-0.375g): 5 patients Magnesium Sulfate: Intra-arterial |
| FG003 | Regional/ Distal (50/50%) Magnesium 1.5g | Regional/ Distal (50% TD regional- 0.75g/ 50% distal-0.75g): 5 patients Magnesium Sulfate: Intra-arterial |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
4 patients were enrolled (regional intra-arterial Magnesium 0.75g) before the study was stopped (not due to safety concerns). They were all enrolled in the first group
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| ID | Title | Description |
|---|---|---|
| BG000 | Regional Intra-arterial Magnesium 0.75g | Regional only 0.75 mg Magnesium Sulfate (50% Total Dose): 5 patients Magnesium Sulfate: Intra-arterial |
| BG001 | Regional Intra-arterial Magnesium 1.5g |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Magnesium Concentration in Region of Cerebral Ischemia | Peripheral Magnesium Levels, meq/L will be obtained through the femoral sheath at the beginning (baseline) and end (post-treatment) of each case. These will be averaged to obtain a femoral Magnesium level. Magnesium levels distal to the occlusion will be measured at the first pass of the clot retrieving device. | Enrollment only occurred in the first arm (lowest dose) of the study as the arms were planned to enroll sequentially. The study was not stopped due to safety concerns | Posted | Mean | Standard Deviation | meq/L | Mg level: 1) Peripheral: Baseline and post-treatment (averaged); 2) Distal: after first pass of the clot retriever |
|
90 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Regional Intra-arterial Magnesium 0.75g | Regional only 0.75 mg Magnesium Sulfate (50% Total Dose): 5 patients Magnesium Sulfate: Intra-arterial |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Aspiration Pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cerebral Edema | Nervous system disorders | Systematic Assessment |
The trial was terminated early (with enrollment only in the first arm) by the investigators due to low enrollment (given results of relevant studies at the time) . There were no safety concerns with the trial or the agent.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. William J Mack | University of Southern California | 323 442 7512 | william.mack@med.usc.edu |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D008278 | Magnesium Sulfate |
| ID | Term |
|---|---|
| D017616 | Magnesium Compounds |
| D007287 | Inorganic Chemicals |
| D013431 | Sulfates |
| D013464 | Sulfuric Acids |
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| University of Southern California University and LA County Hospitals |
| Los Angeles |
| California |
| 90033 |
| United States |
Regional Intra-arterial magnesium Sulfate Only 1.5g (100% TD): 5 patients
Magnesium Sulfate: Intra-arterial
| BG002 | Regional/ Distal (75/25%) Magnesium 1.5g | Regional/ Distal(75% TD regional- 1.125g / 25% distal-0.375g): 5 patients Magnesium Sulfate: Intra-arterial |
| BG003 | Regional/ Distal (50/50%) Magnesium 1.5g | Regional/ Distal (50% TD regional- 0.75g/ 50% distal-0.75g): 5 patients Magnesium Sulfate: Intra-arterial |
| BG004 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| OG001 | Regional Intra-arterial Magnesium 1.5g | Regional Intra-arterial magnesium Sulfate Only 1.5g (100% TD): 5 patients Magnesium Sulfate: Intra-arterial |
| OG002 | Regional/ Distal (75/25%) Magnesium 1.5g | Regional/ Distal(75% TD regional- 1.125g / 25% distal-0.375g): 5 patients Magnesium Sulfate: Intra-arterial |
| OG003 | Regional/ Distal (50/50%) Magnesium 1.5g | Regional/ Distal (50% TD regional- 0.75g/ 50% distal-0.75g): 5 patients Magnesium Sulfate: Intra-arterial |
|
|
| Secondary | Number of Participants With Procedure Related Serious Adverse Event | Periprocedural clinical, radiographic and laboratory data will be collected and analyzed to detect Mg related adverse events. Outcome will be assessed perioperatively and at 24 hours, 30 days (+/- 10 days) and 90 days (+/- 15 days) | Posted | Count of Participants | Participants | intraprocedure, postoperative day 1, 1 month, 3 month |
|
|
|
| 0 |
| 4 |
| 1 |
| 4 |
| 2 |
| 4 |
| EG001 | Regional Intra-arterial Magnesium 1.5g | Regional Intra-arterial magnesium Sulfate Only 1.5g (100% TD): 5 patients Magnesium Sulfate: Intra-arterial | 0 | 0 | 0 | 0 | 0 | 0 |
| EG002 | Regional/ Distal (75/25%) Magnesium 1.5g | Regional/ Distal(75% TD regional- 1.125g / 25% distal-0.375g): 5 patients Magnesium Sulfate: Intra-arterial | 0 | 0 | 0 | 0 | 0 | 0 |
| EG003 | Regional/ Distal (50/50%) Magnesium 1.5g | Regional/ Distal (50% TD regional- 0.75g/ 50% distal-0.75g): 5 patients Magnesium Sulfate: Intra-arterial | 0 | 0 | 0 | 0 | 0 | 0 |
| Gastrointestinal bleed | Gastrointestinal disorders | Systematic Assessment |
|
| Parotiditis with sepsis | Blood and lymphatic system disorders | Systematic Assessment |
|
| Ischemic change on brain imaging | Nervous system disorders | Systematic Assessment |
|
| Hemorrhagic Transformation of stroke | Nervous system disorders | Systematic Assessment |
|
| Sick Sinus Syndrome | Cardiac disorders | Systematic Assessment |
|
| Aspiration Pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| increased blood glucose | Endocrine disorders | Systematic Assessment |
|
| Urinary Tract Infection | Renal and urinary disorders | Systematic Assessment |
|
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| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D013456 |
| Sulfur Acids |
| D013457 | Sulfur Compounds |