Safety and Efficacy of the Penumbra™ System in Acute Middle Cerebral Artery (MCA) Stroke

NCT ID: NCT01133223

Last Updated: 2015-09-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE2

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2015-09-30

Brief Summary

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Stroke prognosis is intimately related to reperfusion. Reperfusion in acute setting can be achieved with different strategies - varying from intravenous rtPA from mechanical thrombectomy. Recently, interventional approaches have been gaining attention and playing an increasing role in stroke care. However, no solid scientifical data is available to date. The investigators want do conduct a pilot trial to test if the use of the Penumbra™ System can improve clinical outcomes in a specific stroke setting.

Detailed Description

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Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Thrombectomy

Group Type ACTIVE_COMPARATOR

Penumbra™ System

Intervention Type DEVICE

Patients assigned to the Thrombectomy arm will be conducted to the angio suite. Mechanical thrombectomy will be attempted with the use of the Penumbra™ System, and can be assisted by intraarterial thrombolysis (rTPA up to 20 mg)

Usual Care

Group Type ACTIVE_COMPARATOR

Recombinant tissue plasminogen activator

Intervention Type DRUG

Patients assigned to Usual Care arm will be thrombolysed according to the NINDS protocol (rtPA 0,9 mg/kg, 10% IV bolus and remaining in the next hour, up to 90 mg)

Interventions

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Penumbra™ System

Patients assigned to the Thrombectomy arm will be conducted to the angio suite. Mechanical thrombectomy will be attempted with the use of the Penumbra™ System, and can be assisted by intraarterial thrombolysis (rTPA up to 20 mg)

Intervention Type DEVICE

Recombinant tissue plasminogen activator

Patients assigned to Usual Care arm will be thrombolysed according to the NINDS protocol (rtPA 0,9 mg/kg, 10% IV bolus and remaining in the next hour, up to 90 mg)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient enrolled in acute ischemic stroke protocol
* Up to 3,5h from symptoms onset
* Clinical findings compatible with middle cerebral artery syndrome
* Angiotomographic evidence of proximal middle cerebral artery occlusion

Exclusion Criteria

* NIHSS \< 10
* Overt contraindication to thrombolysis or angiopgraphy
* Disagreement with informed consent term or refusal to participate
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital de Clinicas de Porto Alegre

OTHER

Sponsor Role lead

Responsible Party

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Lucas Scotta Cabral

Lucas Scotta Cabral

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sheila Cristina Ouriques Martins, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital de Clinicas de Porto Alegre

Locations

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Hospital de Clinicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Countries

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Brazil

References

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Hacke W, Kaste M, Bluhmki E, Brozman M, Davalos A, Guidetti D, Larrue V, Lees KR, Medeghri Z, Machnig T, Schneider D, von Kummer R, Wahlgren N, Toni D; ECASS Investigators. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008 Sep 25;359(13):1317-29. doi: 10.1056/NEJMoa0804656.

Reference Type BACKGROUND
PMID: 18815396 (View on PubMed)

Ernst R, Pancioli A, Tomsick T, Kissela B, Woo D, Kanter D, Jauch E, Carrozzella J, Spilker J, Broderick J. Combined intravenous and intra-arterial recombinant tissue plasminogen activator in acute ischemic stroke. Stroke. 2000 Nov;31(11):2552-7. doi: 10.1161/01.str.31.11.2552.

Reference Type BACKGROUND
PMID: 11062274 (View on PubMed)

Wolpert SM, Bruckmann H, Greenlee R, Wechsler L, Pessin MS, del Zoppo GJ. Neuroradiologic evaluation of patients with acute stroke treated with recombinant tissue plasminogen activator. The rt-PA Acute Stroke Study Group. AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):3-13.

Reference Type BACKGROUND
PMID: 8427107 (View on PubMed)

Mattle HP, Arnold M, Georgiadis D, Baumann C, Nedeltchev K, Benninger D, Remonda L, von Budingen C, Diana A, Pangalu A, Schroth G, Baumgartner RW. Comparison of intraarterial and intravenous thrombolysis for ischemic stroke with hyperdense middle cerebral artery sign. Stroke. 2008 Feb;39(2):379-83. doi: 10.1161/STROKEAHA.107.492348. Epub 2007 Dec 20.

Reference Type BACKGROUND
PMID: 18096842 (View on PubMed)

Agarwal P, Kumar S, Hariharan S, Eshkar N, Verro P, Cohen B, Sen S. Hyperdense middle cerebral artery sign: can it be used to select intra-arterial versus intravenous thrombolysis in acute ischemic stroke? Cerebrovasc Dis. 2004;17(2-3):182-90. doi: 10.1159/000075789. Epub 2003 Dec 29.

Reference Type BACKGROUND
PMID: 14707420 (View on PubMed)

Noser EA, Shaltoni HM, Hall CE, Alexandrov AV, Garami Z, Cacayorin ED, Song JK, Grotta JC, Campbell MS 3rd. Aggressive mechanical clot disruption: a safe adjunct to thrombolytic therapy in acute stroke? Stroke. 2005 Feb;36(2):292-6. doi: 10.1161/01.STR.0000152331.93770.18. Epub 2004 Dec 29.

Reference Type BACKGROUND
PMID: 15625300 (View on PubMed)

Berlis A, Lutsep H, Barnwell S, Norbash A, Wechsler L, Jungreis CA, Woolfenden A, Redekop G, Hartmann M, Schumacher M. Mechanical thrombolysis in acute ischemic stroke with endovascular photoacoustic recanalization. Stroke. 2004 May;35(5):1112-6. doi: 10.1161/01.STR.0000124126.17508.d3. Epub 2004 Mar 11.

Reference Type BACKGROUND
PMID: 15017011 (View on PubMed)

Schumacher HC, Meyers PM, Yavagal DR, Harel NY, Elkind MS, Mohr JP, Pile-Spellman J. Endovascular mechanical thrombectomy of an occluded superior division branch of the left MCA for acute cardioembolic stroke. Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):305-8. doi: 10.1007/s00270-003-2719-5.

Reference Type BACKGROUND
PMID: 14562985 (View on PubMed)

Kulcsar Z, Bonvin C, Pereira VM, Altrichter S, Yilmaz H, Lovblad KO, Sztajzel R, Rufenacht DA. Penumbra system: a novel mechanical thrombectomy device for large-vessel occlusions in acute stroke. AJNR Am J Neuroradiol. 2010 Apr;31(4):628-33. doi: 10.3174/ajnr.A1924. Epub 2009 Dec 17.

Reference Type BACKGROUND
PMID: 20019113 (View on PubMed)

Bose A, Henkes H, Alfke K, Reith W, Mayer TE, Berlis A, Branca V, Sit SP; Penumbra Phase 1 Stroke Trial Investigators. The Penumbra System: a mechanical device for the treatment of acute stroke due to thromboembolism. AJNR Am J Neuroradiol. 2008 Aug;29(7):1409-13. doi: 10.3174/ajnr.A1110. Epub 2008 May 22.

Reference Type BACKGROUND
PMID: 18499798 (View on PubMed)

Other Identifiers

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GPPG 09-587

Identifier Type: -

Identifier Source: org_study_id

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