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Prospective, Single-arm, Multi-centre Study to Evaluate the Efficacy and Safety of the iNstroke 4F Thromboaspiration Catheter in Patients with Acute Ischaemic Stroke due to Primary Distal Medium Vessel Occlusions.
This study is an exploratory, interventional, open label, single-arm, multi-centre prospective clinical investigation.
In this post-market clinical investigation, the aim is to further evaluate the efficacy and safety of the iNstroke 4F aspiration catheter, with a view to, in future clinical investigations, comparing the product with the standard therapy or with other similar products. In addition, this clinical investigation will generate results that could be used to further assess the safety and effectiveness of mechanical thrombectomy for the treatment of DMVO.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Thromboaspiration using iNstroke 4F aspiration catheter | Other | No comparator will be used in this clinical investigation as it is an exploratory study of a CE-marked medical device to be used within the scope of its intended purpose. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thromboaspiration catheter | Device | Patients to undergo thromboaspiration with iNstroke 4F |
|
| Measure | Description | Time Frame |
|---|---|---|
| Recanalization Endpoint | Recanalization rate with a modified thrombolysis in cerebral infarction scale (mTICI) score ≥2b in ≤3 revascularization passes using iNstroke 4F aspiration catheter, alone or in conjunction with a SR. | Intra-procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Recanalization Endpoint | Proportion of subjects treated with iNstroke 4F alone with complete recanalization in primary DMVO defined as an mTICI ≥2b, after iNstroke 4F aspiration catheter alone (ADAPT) was used as a first-line therapy | Intra-procedure |
| Recanalization Endpoint |
| Measure | Description | Time Frame |
|---|---|---|
| Exploratory Recanalization Endpoint | Proportion of subjects in which a switch of technique (from ADAPT to combined or from combined to ADAPT) with iNstroke 4F aspiration catheter was used to successfully perform the thrombectomy. | Intra-procedure |
| Exploratory Recanalization Endpoint |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitätsklinikum Bonn | Not yet recruiting | Bonn | Germany |
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Proportion of subjects treated with iNstroke 4F in conjunction with a stent retriever having complete recanalization in primary DMVO defined as achieving an mTICI ≥2b, after iNstroke 4F aspiration catheter, in conjunction with a stent retriever (SR), was used as a first-line therapy. |
| Intra-procedure |
| Recanalization Endpoint | Proportion of subjects with mTICI≥2b, mTICI≥2c and mTICI 3 after first pass with iNstroke 4F aspiration catheter used both alone and in conjunction with a SR. | Intra-procedure |
| Recanalization Endpoint | Time from groin puncture to achievement of complete recanalization (mTICI ≥2b), or if not achieved, until the final angiogram time, in patients treated with iNstroke 4F aspiration catheter, alone or in conjunction with a SR, as a first-line therapy. | Intra-procedure |
| Recanalization Endpoint | Proportion of subjects in which direct contact with thrombus is achieved with iNstroke 4F aspiration catheter. | Intra-procedure |
| Clinical Endpoint | Proportion of subjects achieving a modified Rankin scale (mRS) score of 0-2 at the 90-day (±14 days) post-procedure follow-up visit. | 90 day |
| Safety Endpoint | Occurrence of SICH (according to SITS-MOST (13) and ECASS criteria (14)) within 24 (-8/+12) hours post-procedure, assessed by magnetic resonance imaging (MRI)/computed tomography (CT). Intracerebral Haemorrhage (ICH) is defined as the presence of extravascular blood in the brain or within the skull (local or remote parenchymal hematoma type 2, subarachnoid haemorrhage, and/or intraventricular haemorrhage) detected on the post-procedure imaging scan. ICH is considered symptomatic (SICH) if it is associated with a clinical deterioration, determined by a worsening/increase on the National Institutes of Health Stroke Scale (NIHSS) score of ≥4 points, or if it causes death and is identified as the predominant cause of neurological deterioration. | 24 (-8/+12) hours |
| Safety Endpoint | Occurrence of embolization in a previously non-involved (or new) territory as seen on the final control angiogram at the end of the procedure. | Intra-procedure |
| Safety Endpoint | Occurrence of embolization in distal medium territory to the proximal occlusion as seen on the final control angiogram at the end of the procedure. | Intra-procedure |
| Safety Endpoint | Inhospital mortality rate related to the procedure during hospital admission. | During hospital admission |
| Safety Endpoint | Occurrence of devices and procedure related adverse events within 90 days (±14 days) after the procedure. | 90 days (±14 days) after the procedure. |
| Safety Endpoint | Occurrence of procedure-related complications: arterial perforation, arterial dissection and severe vasospasm in the target vessel. | Intra-procedure |
Proportion of subjects in which an aspiration catheter device with a 4F caliber different from iNstroke 4F aspiration catheter was used as a rescue therapy. |
| Intra-procedure |
| Exploratory Recanalization Endpoint | Proportion of cases in which iNstroke 4F aspiration catheter (alone or in conjunction with a SR) successfully reached the site of occlusion. | Intra-procedure |
| Exploratory Recanalization Endpoint | Number of passes with iNstroke 4F aspiration catheter until recanalization. | Intra-procedure |
| Exploratory Recanalization Endpoint | Visibility of the catheter during the thrombectomy rated from 0 to 5 (being 0 the worst and 5 the best score). | Intra-procedure |
| Exploratory Clinical Endpoint | Proportion of subjects with rapid neurological improvement, defined as a decrease of more than 4 points on the NIHSS scale, during the first 24 (-8/+12) hours post-procedure. | 24 (-8/+12) hours post-procedure. |
| Exploratory Clinical Endpoint | Proportion of subjects with a reduction of ≥8 points on the NIHSS scale during the first 24 (-8/+12) hours post-procedure, or with a NIHSS score of 0-1 at 3 days (±24 hours) or at the time of discharge, whichever occurs first. | First 24 (-8/+12) hours post-procedure or 3 days (±24 hours) or at the time of discharge, whichever occurs first. |
| Exploratory Clinical Endpoint | Median of NIHSS score at 24 (-8/+12) hours. | 24 (-8/+12) hours. |
| Exploratory Clinical Endpoint | Median of NIHSS score at 3 days (±24 hours) or at the time of patient discharge, whichever occurs first. | 3 days (±24 hours) post procedure |
| Universitätsklinikum Schleswig-Holstein | Not yet recruiting | Kiel | Germany |
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| Klinikum Marburg | Not yet recruiting | Marburg | Germany |
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| Klinikum Nürnberg | Not yet recruiting | Nuremberg | Germany |
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| Knappschaftskrankenhaus Recklinghausen | Recruiting | Recklinghausen | Germany |
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| Semmelweis University Center | Recruiting | Budapest | Hungary |
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| Hospital Universitario Vall d'Hebron | Recruiting | Barcelona | Spain |
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| Hospital Universitario 12 de Octubre | Not yet recruiting | Madrid | Spain |
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| Hospital Universitario de Getafe | Not yet recruiting | Madrid | Spain |
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| Hospital Universitario La Paz | Not yet recruiting | Madrid | Spain |
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| Hospital Clínico Universitario Virgen de Arrixaca | Recruiting | Murcia | Spain |
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| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| D020521 | Stroke |
| D007511 | Ischemia |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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