- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04904250
Spider Versus Emboshield Distal Protection on Cerebral Microembolization During Vulnerable Plaque in Carotid Artery Stenting (CASH-ES)
June 27, 2022 updated by: Xuanwu Hospital, Beijing
SpiderFX Versus Emboshield Nav6 Distal Protection on Cerebral Microembolization in Vulnerable Plaque During Carotid Artery Stenting
A single center, prospective, outcome-assessor-blinded, randomized controlled trial study (CASH-ES) is designed to compare the efficiency of two different distal embolism protection devices (SpiderFX and Emboshield NAV6) in during CAS procedure of patients with vulnerable plaque.
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
CAS is an alternative to CEA for treating carotid stenosis with a similar efficacy in preventing future stroke.
High-intensity signal in the plaque on the TOF-MRA is associated to a high risk of cerebral embolism during stenting.
The evidence of protection selection in such patients was limited.
A single center, prospective, outcome- assessor-blinded, randomized controlled trial study (CASH-ES) is designed to compare the efficiency of two distal embolism protection devices (SpiderFX and Emboshield NAV6) during CAS procedure of patients with vulnerable plaque.
Asymptomatic patients with internal carotid artery stenosis ≥ 70% (NASCET) and symptomatic patients with a stenosis ≥ 50% who is over 70 years old, diagnostic of vulnerable plaque on ultrasound or have a high-intensity signal in the relevant plaques on TOF-MRA will be included.
Patients are randomized in two balanced groups (1:1) to receive CAS with either distal (Spider FX) or distal (Emboshield NAV6) protection.
The primary endpoint is the incidence of new cerebral ipsilateral ischemic lesions on the DW-MRI within 7-days post operation.
Secondary endpoints include the number, size, location of new cerebral ischemic lesions on the DW-MRI, the counts of MES during TCCD monitoring during procedure, procedural complications, stroke, myocardial infarction, and death within 7 days.
Study Type
Interventional
Enrollment (Anticipated)
172
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Yanfei Chen, MD
- Phone Number: +8613701285010
- Email: chenyanflying@126.com
Study Contact Backup
- Name: Lin Yan, MD
- Phone Number: +8615601204926
- Email: yanlin19910926@163.com
Study Locations
-
-
-
Beijing, China
- Xuanwu Hospital
-
Contact:
- Yanfei Chen, MD
- Phone Number: +8613701285010
- Email: chenyanflying@126.com
-
Contact:
- Lin Yan, MD
- Phone Number: +8615601204926
- Email: yanlin19910926@163.com
-
Principal Investigator:
- Liqun Jiao, MD, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Male and female patients 18 years of age and older.
- Symptomatic patients with internal carotid artery stenosis≥50% on angiography, or asymptomatic patients with internal carotid artery stenosis≥70% on angiography.
- Anatomic characteristics of the lesions that made it possible to use either type of distal embolism protective device (Emboshield or Spider).
- The lesion was located in the internal carotid artery (ICA) or the bifurcation of the carotid artery.
- Only one WALLSTENT is expected to treat target lesions.
- Tolerance to aspirin/clopidogrel/heparin and other drug therapy.
- The patient or legally authorized representative has been informed of the nature of the study, agrees to its provisions, and has provided written informed consent, approved by the appropriate Medical Ethics Committee, Institutional Review Board, or Human Research Ethics Committee.
- High-intensity Signal in the relevant plaques on the TOF-MRA.
Exclusion Criteria:
- Extensive ipsilateral or disabling stroke(mRS≥2) or cerebrovascular events occurred within 1 month combined with neurological defects.
- Myocardial infarction occurred within 72 hours or TIA within 48 hours.
- Atrial fibrillation (chronic or paroxysmal) is not treated with anticoagulation.
- Ipsilateral intracranial artery stenosis with a history of stenting.
- CABG or vascular surgery in the 30-day period before the procedure.
- Acute coronary syndrome in the 30-day period before the procedure.
- Life span within 12 months.
- Patient has a history of bleeding diathesis within 1 month or coagulopathy or patients in whom antiplatelet and/or anticoagulant therapy is contraindicated.
- Intolerance or allergic reaction to a study medication without a suitable management alternative.
- The femoral artery condition is not good enough to enter the guidewire or the sound window is not good enough to conduct intraoperative TCD monitoring of the patient.
- Unfavorable femoral artery anatomy for endovascular intervention or unfavorable acoustic window for intraoperative TCD monitoring.
- With Intracranial tumor and is not considered suitable for inclusion or could not complete the MRI examination.
- WBC<3*109/L, PLT<50*109/L or >700*109/L.
- Pregnant or lactating female patient.
- DSA indicated the target vessel occlusion; The tandem lesions could not be covered by one stent; The target vessel was seriously tortuous or the internal carotid artery was not suitable for WallStent; The aortic arch has severe calcification or tortuosity involving the common carotid artery or brachial trunk; Combined with cerebral AVM or cerebral aneurysms which need treatment; Carotid artery stenosis not caused by atherosclerosis, but arteritis, arterial dissection, congenital malformation of blood vessels, or severe vascular lesions after radiotherapy, etc..
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: SEQUENTIAL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Emboshield NAV6
using Emboshield NAV6 distal embolism protection device during CAS
|
a distall occlusion Emboshield NAV6 will be used as the embolism protection device during CAS
Other Names:
|
ACTIVE_COMPARATOR: SpiderFX
using SpiderFX distal protection device during CAS
|
a distal SpiderFX will be used as the embolism protection device during CAS
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Ipsilateral new ischemic lesions on DWI
Time Frame: Within 7 days post-operation
|
The incidence of ipsilateral new ischemic lesions on DWI after CAS
|
Within 7 days post-operation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
major stroke
Time Frame: within 7 days post-operation
|
the incidence of major stroke after CAS, defined as new onset of neurological symptoms causing an increase of NIHSS ≥ 4 or worsening of existing focal neurological deficit lasting ≥ 24 hours
|
within 7 days post-operation
|
myocardial infarction
Time Frame: within 7 days post-operation
|
the incidence of myocardial infarction after CAS, defined as new onset of chest discomfort or cardiac stroke or heart failure with a rise and/or fall of cardiac biomarkers and ECG abnormalities
|
within 7 days post-operation
|
death
Time Frame: within 7 days post-operation
|
In-hospital mortality
|
within 7 days post-operation
|
Any hemorrhage, acute kidney injury and other procedure-related complications
Time Frame: within 7 days post-operation
|
including major/minor hemorrhage, acute kidney injury, etc.
|
within 7 days post-operation
|
The number of new cerebral ischemic lesions on DW-MRI
Time Frame: within 7 days post-operation
|
The number of new cerebral ischemic lesions on DW-MRI
|
within 7 days post-operation
|
The size of new cerebral ischemic lesions on DW-MRI
Time Frame: within 7 days post-operation
|
The size of new cerebral ischemic lesions on DW-MRI
|
within 7 days post-operation
|
The location of new cerebral ischemic lesions on DW-MRI
Time Frame: within 7 days post-operation
|
The location of new cerebral ischemic lesions on DW-MRI
|
within 7 days post-operation
|
MES counting during CAS
Time Frame: during CAS procedure
|
TCD monitoring of MES counting during CAS
|
during CAS procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Liqun Jiao, MD, PhD, Department of Interventional Neuroradiology, Department of Neurosurgery, International Neuroscience Institute (China-INI), Xuanwu Hospital, Capital Medical University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ANTICIPATED)
August 27, 2022
Primary Completion (ANTICIPATED)
May 31, 2024
Study Completion (ANTICIPATED)
October 1, 2024
Study Registration Dates
First Submitted
April 30, 2021
First Submitted That Met QC Criteria
May 25, 2021
First Posted (ACTUAL)
May 27, 2021
Study Record Updates
Last Update Posted (ACTUAL)
June 30, 2022
Last Update Submitted That Met QC Criteria
June 27, 2022
Last Verified
June 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CASH-ES
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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