- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06370182
Safety and Effectiveness of Mechanical Thrombectomy Using the Anaconda ANA5 Device (ATHENA)
A Prospective, Randomized, Dual-arm Multi-center Study to Assess the Safety and Effectiveness of Mechanical Thrombectomy Using the Anaconda ANA5 Device in Combination With a Stent Retriever
Study Overview
Status
Intervention / Treatment
Detailed Description
The objective of this prospective randomized study is to assess the primary safety and effectiveness of mechanical thrombectomy (MT) using the ANA funnel catheter in its intended use as a device to facilitate the insertion and deployment of other devices (i.e., stent retrievers and intravascular catheters) and to allow flow restriction during MT procedures performed in subjects experiencing acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO) of the internal carotid artery (ICA) and treated within 24 hours of symptom onset.
Acute reperfusion success after one pass (First Pass Effect, FPE) with ANA will be compared to an active control using the same stent retrievers delivered by an approved guide catheter with or without an intermediate catheter per conventional techniques. The study is designed to demonstrate that the use of ANA does not adversely impact the safety and effectiveness of a conventional stent retriever MT procedure.
Similar to other ancillary devices used in MT, the ANA device is designed to facilitate the delivery of stent retrievers and other catheters during these procedures. Its design aims to enhance procedural success and efficiency of stent retriever-based MT procedures by facilitating flow arrest during clot retrieval. This approach has been shown to improve rates of revascularization and good clinical outcome after three months. Numerous studies have established the value of flow arrest during MT, yet it is only used in a minority of procedures most likely due to concerns related to navigability, complexity and safety of the currently available devices.
Use of the ANA to facilitate MT with a stent retriever may provide a simplified approach to flow restriction, and may achieve similar acute reperfusion outcomes to commonly used approaches that combine direct aspiration with an intermediate catheter to actuate clot retrieval with a stent retriever (control). The study will report acute reperfusion success after a single thrombectomy pass with three of the most commonly employed stent retrievers, namely Solitaire, Trevo and pRESET. Procedural safety will be assessed by comparing the rate of procedure related sICH within 24 hours of the intervention between study arms.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Shannon Doppelheuer
- Phone Number: (404) 277-7280
- Email: sdoppelheuer@vastrax.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Key Inclusion Criteria:
- A new focal disabling neurologic deficit consistent with acute cerebral ischemia.
- Baseline National Institutes of Health Stroke Scale (NIHSS) obtained prior to procedure ≥ 8 points and ≤ 25 points.
- Pre-ictal modified Rankin Score (mRS) score of 0,1 or 2.
- Treatable within 24 hours of symptom onset, defined as point in time when the subject was last observed to be asymptomatic; treatment start is defined by arterial puncture time.
- Subjects received thrombolytic therapy in accordance with American Heart Association/American Stroke Association (AHA/ASA) Guidelines within 3 hours of symptom onset unless contraindicated.
- Occlusion (eTICI ≤ 1 flow) of the terminal carotid artery, middle cerebral artery (M1) or dominant proximal M2 segment, indicated for mechanical thrombectomy, confirmed with conventional angiography or Computed Tomographic Angiography/Magnetic Resonance Angiography (CTA/MRA).
Key Exclusion Criteria:
- Subject was diagnosed with a stroke in the past year.
- Clinical symptoms suggestive of bilateral stroke or stroke in multiple territories.
- Severe, sustained uncontrolled hypertension refractory to treatment (systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg).
- Known pregnancy and/or lactating female.
- CT or MRI evidence of hemorrhage (the presence of microbleeds is allowed).
- Significant mass effect with midline shift.
- Evidence of intracranial tumor (except small meningioma).
- History of preexisting stent proximal to or at the occlusion site that may preclude safe deployment or recovery of the stent retriever.
- Vessel tortuosity too difficult to allow endovascular access of the intracranial ICA per investigator judgement. Indicators of vessel tortuosity include but are not limited to the presence of carotid loops and type 3 aortic arches.
- Evidence of tandem lesions, including complete occlusion, high grade stenosis or arterial dissection in the extracranial or internal carotid artery (ICA), requiring treatment or preventing access to thrombus.
- Subjects with known or suspected underlying intracranial atherosclerotic lesions responsible for the target occlusion.
- Subjects with occlusions in multiple vascular territories (e.g., bilateral anterior circulation, or anterior/posterior circulation).
- Anatomical or physiological restrictions (e.g., severe stenosis, vasospasm, high tortuosity, etc.) detected via angiogram likely to result in an inability to position the guide catheter or to deploy the ANA or intermediate catheter in the targeted ICA segment with acceptable vessel diameter as defined in the Instructions for Use.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ANA Funnel Catheter Group
Mechanical thrombectomy using a stent retriever delivered by the ANA device.
|
Mechanical thrombectomy using a stent retriever delivered by the ANA device that enables local flow restriction when deployed.
|
Active Comparator: Control Group
Mechanical thrombectomy using a stent retriever delivered by an approved guide catheter.
|
Mechanical thrombectomy using a stent retriever delivered by an approved guide catheter with or without an intermediate catheter and aspiration per conventional techniques.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of subjects with "near-complete" reperfusion after one thrombectomy pass (FPE, eTICI 2c-3, extended Thrombolysis in Cerebral Infarction scale) in the target vessel after one reperfusion attempt.
Time Frame: intra-operative
|
Reperfusion to be assessed by an independent Core Lab.
|
intra-operative
|
Rate of symptomatic intracranial hemorrhage (sICH), attributable to the device or procedure.
Time Frame: Within 24 hours of the procedure
|
Extent of hemorrhage to be assessed by an independent Core Lab, symptoms to be assessed by the Data Monitoring Committee (DMC).
|
Within 24 hours of the procedure
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Adnan Siddiqui, MD, PhD, FAHA, Jacobs School of Medicine & Biomedical Sciences
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ANA2401
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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