Hybrid Operating Treatment of Coexistence of Intracranial Aneurysms and Cerebrovascular Stenosis

NCT ID: NCT03204435

Last Updated: 2017-07-02

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

196 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2019-12-31

Brief Summary

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To evaluate the clinical benefits and risks of hybrid operating techniques in management of intracranial aneurysms with coexistence of atherosclerotic intracranial arterial stenosis.

Detailed Description

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Purpose: Have an evaluation of clinical benefits and risks of hybrid operating techniques in management of intracranial aneurysms (IAs) with coexistence of atherosclerotic intracranial arterial stenosis (AIAS), whose management strategies are inconsistent. Meanwhile, as a new cooperative interventional modality, optimized workflows, technical key knots and operation routines will be explored in the study.

Objects: Patients with IAs with coexistence of AIAS, coincident with inclusion and exclusion criterion and admitted in participating organizations.

Methods: Patients will be distributed into 2 groups, including traditional therapy group(control group) and hybrid operating group(trial group), and conduct with traditional multi-stage neurosurgical management or one-stage hybrid operating management correspondingly. The morbidity rate of peri-operative cerebral hemorrhagic/ischemic event is considered to be the primary observing indicator, and morbidity rate of peri-operative cerebral hemorrhagic/ischemic event, while peri-operative mortality rate, and health-economic indicators are secondary indicators.The information of operations will be recorded in detail as evidence of optimization of workflow and technical key knots.

Conditions

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Intracranial Aneurysm Cerebrovascular Stenosis Atheroscleroses, Cerebral

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Patients of intracranial aneurysms with coexistence of cerebrovascular stenosis, coincident with inclusion and exclusion criterion, will be distributed into traditional therapy group(control group) and hybrid operating group(test group), and conduct with traditional neurosurgical management or one-stage hybrid operating management separately.

Traditional therapy group: intervene the aneurysms and vascular stenosis unsimultaneously. Clipping procedure is preferred to aneurysms, while endovascular intervention is preferred to stenosis.

Hybrid operation group: one-stage hybrid operating technique is conducted. The aneurysms and vascular stenosis will be executed via the cooperation of microsurgical procedure and endovascular interventional techniques.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Traditional therapy

Consists of microsurgical aneurysmal operating techniques, endovascular techniques for intracranial aneurysms, endovascular techniques for cerebrovascular stenosis, and carotid endarterectomy, which are presented by stages.

Group Type OTHER

Microsurgical aneurysmal operating techniques

Intervention Type PROCEDURE

The microsurgical techniques used to evacuate the aneurysm out of circulation or reduce its risk of rupture by aneurysmal clipping, wrapping,or isolation.

endovascular techniques for cerebrovascular stenosis

Intervention Type PROCEDURE

The endovascular techniques that recanalize the narrowed or occluded cerebrovascular, including stent implantation, balloon dilatation.

endovascular techniques for intracranial aneurysms

Intervention Type PROCEDURE

The endovascular techniques that embolize the cavity of aneurysms to reduce the risk of rupture, including coiling embolization, balloon-assisted occlusion.

carotid endarterectomy

Intervention Type PROCEDURE

A microsurgical technique to recanalize the stenosis or occluded proximal segment of carotid artery.

Hybrid operation

Consists of microsurgical aneurysmal operating techniques, endovascular techniques for intracranial aneurysms, endovascular techniques for cerebrovascular stenosis, and carotid endarterectomy, which are presented in one-stage in hybrid operating theater.

Group Type EXPERIMENTAL

Microsurgical aneurysmal operating techniques

Intervention Type PROCEDURE

The microsurgical techniques used to evacuate the aneurysm out of circulation or reduce its risk of rupture by aneurysmal clipping, wrapping,or isolation.

endovascular techniques for cerebrovascular stenosis

Intervention Type PROCEDURE

The endovascular techniques that recanalize the narrowed or occluded cerebrovascular, including stent implantation, balloon dilatation.

endovascular techniques for intracranial aneurysms

Intervention Type PROCEDURE

The endovascular techniques that embolize the cavity of aneurysms to reduce the risk of rupture, including coiling embolization, balloon-assisted occlusion.

carotid endarterectomy

Intervention Type PROCEDURE

A microsurgical technique to recanalize the stenosis or occluded proximal segment of carotid artery.

Interventions

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Microsurgical aneurysmal operating techniques

The microsurgical techniques used to evacuate the aneurysm out of circulation or reduce its risk of rupture by aneurysmal clipping, wrapping,or isolation.

Intervention Type PROCEDURE

endovascular techniques for cerebrovascular stenosis

The endovascular techniques that recanalize the narrowed or occluded cerebrovascular, including stent implantation, balloon dilatation.

Intervention Type PROCEDURE

endovascular techniques for intracranial aneurysms

The endovascular techniques that embolize the cavity of aneurysms to reduce the risk of rupture, including coiling embolization, balloon-assisted occlusion.

Intervention Type PROCEDURE

carotid endarterectomy

A microsurgical technique to recanalize the stenosis or occluded proximal segment of carotid artery.

Intervention Type PROCEDURE

Other Intervention Names

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microsurgical aneurysmal clipping microsurgical aneurysmal wrapping microsurgical aneurysmal isolation endovascular stenting endovascular balloon dilatation endovascular coiling endovascular balloon occlusion flow diverter

Eligibility Criteria

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Inclusion Criteria

* For aneurysms:
* with diagnosed complex intracranial aneurysm by digital subtraction angiography(DSA);
* got SAH in history;
* neural functional deficits due to aneurysms;
* with \<4 in Hunt-Hess Grades;
* ≥5.0mm in the maximum diameter;
* \<70 years old;
* with irregular morphological features and high rupture risk.

and for stenosis

* Intracranial vessels:
* \>50% in rate of stenosis with ischemic symptoms/perfusing evidence/lacunar infarction in supplying territory, failed in conservative treatment;
* with a deliverable position of intracranial stents devices.
* or Vertebral arterial system:
* ≥70% in the rate of stenosis, with contralateral vertebral arterial occlusion;
* symptomatic vertebral arterial stenosis, accompanied with posterior inferior cerebellum artery derived from the affected artery and related symptoms are caused/clinical benefits can be achieved through angioplasty.
* or Extracranial arterial system:
* ≥70% in the rate of stenosis with symptoms;
* nonsymptomatic patients, ≥70% in the rate of stenosis , with perfusing evidence.

Exclusion Criteria

* \>70 in age, with low rupture risk;
* stroke history in 6 weeks (contraindication for endovascular intervention);
* coexistence with intracranial tumor or AVM;
* cannot tolerant the operation;
* patient or relative refuses to participate the trail
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Beijing Municipal Science & Technology Commission

OTHER

Sponsor Role collaborator

liuxingju

OTHER_GOV

Sponsor Role lead

Responsible Party

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liuxingju

Researcher

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jizong Zhao, MD

Role: STUDY_DIRECTOR

Beijing Tiantan Hospital

Locations

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Beijing Tiantan Hospital Capital Medical University

Beijing, Beijing Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xingju Liu, MD

Role: CONTACT

86-010-67096523

Mingze Wang, MD

Role: CONTACT

86-010-67096510

Facility Contacts

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Xingju Liu, MD

Role: primary

86-010-670965423

Mingze Wang, MD

Role: backup

86-010-67096510

Other Identifiers

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BJTTH-005

Identifier Type: -

Identifier Source: org_study_id

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