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Implant for Augmentation of Cerebral Blood Flow Trial, Effectiveness and Safety in a 24 Hour Window (ImpACT-24A) (ImpACT-24A)

2019년 1월 25일 업데이트: BrainsGate

A Multicenter, Randomized, Double Blind, Sham Control, Parallel Arm Trial to Assess Effectiveness and Safety of the Ischemic Stroke System ISS, as an Adjunct to Standard of Care in Subjects With Acute Ischemic Stroke

The primary objective of the study is to assess the safety and effectiveness of SPG stimulation with the ISS in patients with an acute ischemic stroke in the anterior circulation initiated within 24 hours from stroke onset.

연구 개요

상세 설명

This study was first registered as NCT00826059 on January 19, 2009 under the name ImpACT-24.

Background:

Recruitment to ImpACT-24 was halted, the protocol was amended and then the study was resumed. Later, it was decided to define the first part (before the halt) as a separate study - ImpACT-24A, and identify the continuation of the study as ImpACT-24B. ImpACT-24B continues to be registered as NCT00826059, and ImpACT-24A is registered in this new record.

Detailed Description:

A multi-center, multinational, randomized, double blind, sham control, adjunctive to Standard of Care, parallel arm study with ongoing DSMB review of accumulated safety data.

Screening:

Treatment should be initiated between 8 and 24 hours from stroke onset. All screened patients will be identified by patient number and will sign the informed consent prior to any study procedure initiation.

Period 1: Day 1-5

Day 1- Eligible subjects will be randomized in a 2:1 (ISS Stimulation: Sham Control) ratio:

Group 1: Implantation and ISS Stimulation during five consecutive days & Standard of Care Group 2: Implantation and Sham Stimulation during five consecutive days & Standard of Care The implantation will be performed by a trained physician. Stimulation/sham stimulation will be delivered Day 2-5 ISS / Sham Stimulation will be repeated during the following four consecutive days by trained personnel within 18-26 hours from preceding stimulation.

Day 5 / Day of Discharge. Following the last ISS /Sham Stimulation, explantation will be performed.

Subjects will continue with Standard of Care as needed and will be released from the hospital upon investigator's judgment.

Period 2: Day of Discharge - 90±7 days During this period both groups (ISS Stimulation and Sham Control) will be treated according to Standard of Care either at the hospital, rehabilitation center or at home.

Scheduled visits will be performed on day 30±7 and day 60 ±7, which will include safety and effectiveness assessments.

Final Visit Day 90±7 days: The final visit will be performed at the study site and will include safety and effectiveness evaluations.

Patients will be contacted by study personnel via telephone on Day 180±7 and on Day 360±7 in order to assess their quality of life status.

연구 유형

중재적

등록 (실제)

327

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • Erlangen, 독일
        • Erlangen University Clinic
      • Essen, 독일
        • Essen University Clinic
      • Heidelberg, 독일
        • Heidelberg University Clinic
      • Leipzig, 독일
        • Leipzig University Clinic
      • Münster, 독일
        • Munster University Clinic
    • Tennessee
      • Chattanooga, Tennessee, 미국, 37404
        • Erlanger Stroke Center
      • Barcelona, 스페인
        • Hospital Vall d'Hebron
      • Girona, 스페인
        • Hospital Universitari de Girona

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  1. Age: ≥ 18 years and ≤ 85 of both genders.
  2. Clinical diagnosis of an acute ischemic stroke in the Carotid, Middle or Anterior Cerebral Artery territories
  3. Baseline NIHSS ≥ 7 and ≤ 18
  4. Ability to initiate treatment within 8- 24 hours from stroke onset.

Exclusion Criteria:

  1. Intracranial hemorrhage or hemorrhagic transformation
  2. Massive stroke
  3. Acute ischemic stroke in the posterior circulation
  4. Minor stroke
  5. Treated with IV-tPA ,IA-tPA or neurothrombectomy devices for the current stroke
  6. Previous stroke in the last 6 months or pre-existing disability
  7. Patients with bleeding propensity or any condition in the oral cavity that prevents implantation
  8. Known cerebral arteriovenous malformation, cerebral aneurysm.
  9. Clinical suspicion of septic embolus.
  10. Uncontrolled hypertension (systolic >185 mmHg and/or diastolic >110 mmHg)
  11. Serious systemic infection.
  12. Women known to be pregnant or having a positive or indeterminate pregnancy test.
  13. Patients with other implanted neural stimulator/ electronic devices (pacemakers).
  14. Life expectancy < 1 year from causes other than stroke.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 네 배로

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Active Stimulation
Device: The Ischemic Stroke System SPG stimulation and standard of care
SPG stimulation and standard of care
가짜 비교기: Sham Stimulation
Device: Sham control Sham stimulation and standard of care
Sham SPG stimulation and standard of care

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Sliding Dichotomy modified Rankin Scale (mRS) at 3 months
기간: 90 ±7 days

Final global disability level on the modified Rankin scale (mRS) at 3 months better than expectation (sliding dichotomy analysis) ) assessed in the modified intention to treat (mITT) population defined as all randomized subjects receiving at least the minimal exposure of 1 treatment (ISS Stimulation or Sham Control) session out of the 5 planned sessions.

mRS Scale:

  • 0 - No symptoms.
  • 1 - No significant disability. Able to carry out all usual activities, despite some symptoms.
  • 2 - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
  • 3 - Moderate disability. Requires some help, but able to walk unassisted.
  • 4 - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
  • 5 - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
  • 6 - Dead.
90 ±7 days
Number of participants with Serious Adverse Events
기간: 90 ±7 days
Comparison between the active and sham stimulation groups of all serious adverse events (SAEs)
90 ±7 days
Number of participants with neurological deterioration
기간: 10 days
Comparison between the active and sham stimulation groups of the rate of neurological deterioration, defined as an increase of 4 or more points on the NIHSS related to any neurological event within the first 10 days after stroke onset
10 days
Number of participants with implantation complications
기간: 90 ±7 days
The rate of implantation complications as classified by the investigator
90 ±7 days
Number of participants with stimulation-related adverse events
기간: 90 ±7 days
Comparison between the active and sham stimulation groups of stimulation-related adverse events as classified by the investigator
90 ±7 days
Mortality rate
기간: 90 ±7 days
Comparison of mortality rates between the active and sham stimulation groups
90 ±7 days

2차 결과 측정

결과 측정
측정값 설명
기간
Sliding Dichotomous 90-day mRS for patients with Aphasia at baseline
기간: 90 ±7 days

Sliding Dichotomous 90-day mRS for patients with Aphasia at baseline

mRS Scale:

  • 0 - No symptoms.
  • 1 - No significant disability. Able to carry out all usual activities, despite some symptoms.
  • 2 - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
  • 3 - Moderate disability. Requires some help, but able to walk unassisted.
  • 4 - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
  • 5 - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
  • 6 - Dead.
90 ±7 days
Binary NIHSS at Day 90
기간: 90 ±7 days

Binary NIHSS (success for score ≤1 or for ≥ 9-point improvement versus baseline)

The NIHSS (National Institute of Health Stroke Score) is a 42-point scale that quantifies neurological deficits in 11 categories. Ratings for each item are scored with 3 to 5 grades, with 0 as normal.

90 ±7 days
Stroke-related quality of life at 3 months: Stroke Impact Scale-16
기간: 90 ±7 days

Stroke-related quality of life at 3 months according to the Stroke Impact Scale-16 (SIS-16)

The scale is based on a questionnaire with 16 items. Each answer ranges from 1 (poor) to 5 (good). A final single-item Recovery domain assesses the individual's perception of his/her recovery from stroke, where:

0 = no recovery 100 = full recovery.

Domain scores range from 0-100 and are calculated using the following equation:

Domain score = [(Mean item score - 1) / (5-1) ] x 100

90 ±7 days

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2009년 1월 1일

기본 완료 (실제)

2011년 1월 1일

연구 완료 (실제)

2012년 3월 1일

연구 등록 날짜

최초 제출

2018년 12월 5일

QC 기준을 충족하는 최초 제출

2018년 12월 5일

처음 게시됨 (실제)

2018년 12월 6일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2019년 1월 28일

QC 기준을 충족하는 마지막 업데이트 제출

2019년 1월 25일

마지막으로 확인됨

2018년 12월 1일

추가 정보

이 연구와 관련된 용어

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