Drug Eluting Stenting and Aggressive Medical Treatment for Preventing Recurrent Stroke in Intracranial Atherosclerotic Disease Trial

NCT ID: NCT04948749

Last Updated: 2024-12-27

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

RECRUITING

Clinical Phase

NA

Total Enrollment

792 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-02

Study Completion Date

2026-12-31

Brief Summary

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The aim of DREAM-PRIDE is to evaluate whether implantation of drug-eluting stent (DES) combined with aggressive medical treatment is more efficacious in prevention of 1-year stroke recurrence than standard medical treatment alone for symptomatic intracranial atherosclerotic disease.

Detailed Description

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This trial is a prospective, multi-center, 1:1 randomized using drug-eluting (Sirolimus) stent combined with aggressive medical treatment versus standard medical treatment to treat symptomatic intracranial atherosclerotic disease. Primary efficacy endpoints (any of the following): 1) any stroke or death within 30 days after enrollment, 2) any stroke or death within 30 days after a revascularization procedure of the qualifying lesion during follow-up, 3) ischemic stroke in the territory of the qualifying artery beyond 30 days to 1 year.

Conditions

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ICAD - Intracranial Atherosclerotic Disease ICAS - Intracranial Atherosclerosis Drug-eluting Stent Stroke Drug Eluting Stents (DES) Medical Treatment

Keywords

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Stroke Drug-eluting stent Medical treatment ICAD-Intracranial Atherosclerotic Disease ICAS-Intracranial Atherosclerosis Drug Eluting Stents (DES)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Drug-eluting stent implantation with aggressive medical treatment group

DES implantation (The Maurora ® Sirolimus Eluting Stent System) combined with aggressive medical treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 mg per day, or ticagrelor 90 mg twice per day for 6 months); management of risk factors (hypertension, diabetes, lipoprotein metabolism disorder, smoking and exercise)

Group Type EXPERIMENTAL

Drug Eluting Stent implantation

Intervention Type DEVICE

The Maurora ® Sirolimus Eluting Stent System for intracranial PTA treatment comprises of a balloon expandable sirolimus eluting stent and a delivery catheter that features a rapid exchange catheter design with a semi-compliant balloon located at its distal end.

Aggressive medical treatment

Intervention Type DRUG

Aggressive medical treatment consists of dual antiplatelet treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 per day mg, or ticagrelor 90 mg twice per day for 6 months after enrollment).

Risk factor management

Intervention Type BEHAVIORAL

Management of risk factors (hypertension, diabetes, lipoprotein metabolism disorder, smoking and exercise)

Standard medical treatment group

Standard medical treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 mg per day, or ticagrelor 90 mg twice per day for 3 months after enrolment), management of risk factors (hypertension, diabetes, lipoprotein metabolism disorder, smoking and exercise)

Group Type ACTIVE_COMPARATOR

Risk factor management

Intervention Type BEHAVIORAL

Management of risk factors (hypertension, diabetes, lipoprotein metabolism disorder, smoking and exercise)

Standard medical treatment

Intervention Type DRUG

Standard medical treatment consists of dual antiplatelet treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 per day mg, or ticagrelor 90 mg twice per day for 3 months after enrollment).

Interventions

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Drug Eluting Stent implantation

The Maurora ® Sirolimus Eluting Stent System for intracranial PTA treatment comprises of a balloon expandable sirolimus eluting stent and a delivery catheter that features a rapid exchange catheter design with a semi-compliant balloon located at its distal end.

Intervention Type DEVICE

Aggressive medical treatment

Aggressive medical treatment consists of dual antiplatelet treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 per day mg, or ticagrelor 90 mg twice per day for 6 months after enrollment).

Intervention Type DRUG

Risk factor management

Management of risk factors (hypertension, diabetes, lipoprotein metabolism disorder, smoking and exercise)

Intervention Type BEHAVIORAL

Standard medical treatment

Standard medical treatment consists of dual antiplatelet treatment (aspirin 100 mg per day for the entire follow-up, clopidogrel 75 per day mg, or ticagrelor 90 mg twice per day for 3 months after enrollment).

Intervention Type DRUG

Other Intervention Names

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Maurora ® Sirolimus Eluting Stent implantation Dual antiplatelet therapy for 6 months Risk factor and life style management Dual antiplatelet therapy for 3 months

Eligibility Criteria

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Inclusion Criteria

1. Age from 18 to 85 years
2. Patients with ischemic stroke within 30 days of enrolment attributed to 70% to 99% stenosis of a major intracranial artery (internal carotid artery \[C4-C7\], middle cerebral artery \[M1\], vertebral artery \[V4\], or basilar artery) on CTA (According to WASID method)
3. The diameter of the target vessel between 2.0mm - 4.5mm
4. The stenosis lesion length ≤ 14 mm
5. Baseline modified Rankin Scale (mRS) score ≤ 3
6. Patient understands the purpose and requirements of the study, and has provided informed consent

Exclusion Criteria

1. Ischemic stroke occurred within 7 days before enrolment
2. Tandem extracranial or intracranial stenosis (70%-99%) or occlusion that is proximal or distal to the target intracranial lesion (NOTE: an exception is allowed if stenosis or occlusion involves a single vertebral artery proximal to a symptomatic basilar artery stenosis and the contralateral vertebral artery is supplying the basilar artery)
3. Bilateral intracranial vertebral artery stenosis of 70%-99% and uncertainty about which artery is symptomatic (NOTE: an exception is that if bilateral vertebral arteries with 70%-99% stenosis but unequal in size, the dominant side is considered as symptomatic)
4. Unilateral vertebral artery stenosis of 70%-99% with normal contralateral vertebral artery
5. Stroke caused by perforating artery occlusion
6. CT angiographic evidence of severe calcification at target lesion
7. Any history of brain parenchymal or subarachnoid, subdural or extradural haemorrhage in the past 6 weeks
8. Intracranial artery stenosis caused by non-atherosclerotic lesions, including: arterial dissection, Moyamoya disease, vasculitis disease, herpes zoster, varicella-zoster or other viral vascular diseases, neurosyphilis, any other intracranial infections, any intracranial stenosis related to cerebrospinal fluid cells, radiation-induced vascular disease, fibromuscular dysplasia, sickle cell disease, neurofibromatosis, central nervous system benign vascular disease, postpartum vascular disease, suspected vasospasm, suspicious embolism recanalization, etc
9. History of stenting of an intracranial artery
10. Presence of any unequivocal cardiac source of embolism
11. Combined with intracranial tumor, aneurysm or intracranial arteriovenous malformation
12. Cannot tolerate dual antiplatelet therapy
13. Contraindications to heparin, rapamycin, contrast and local or general anesthesia
14. Hemoglobin\<100g/L, platelet count \<100×109/L
15. Severe hepatic and renal dysfunction
16. INR\>1.5 or there are uncorrectable factors leading to bleeding
17. Major surgery within the past 30 days or planned within 90 days
18. Renal artery, iliac artery, and coronary artery requiring simultaneous intervention
19. Life expectancy \<1 year
20. Pregnant or lactating women
21. Cannot complete the follow-up due to cognitive, emotional or mental illness
22. Other situations that are not suitable for enrolment according to the judgement of the investigator
23. Enrolment in another study that would conflict with the current study
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Beijing Tiantan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yongjun Wang, MD

Role: PRINCIPAL_INVESTIGATOR

Beijing Tiantan Hospital

Zhongrong Miao, MD

Role: PRINCIPAL_INVESTIGATOR

Beijing Tiantan Hospital

Locations

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Beijing Tiantan Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Beijing Daxing District People's Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Hejian People's Hospital

Cangzhou, Hebei, China

Site Status RECRUITING

North China University of Science and Technology Affiliated Hospital

Tangshan, Hebei, China

Site Status RECRUITING

Xingtai City Third Hospital

Xingtai, Hebei, China

Site Status RECRUITING

General Hospital of The Yangtze River Shipping

Wuhan, Hubei, China

Site Status RECRUITING

Baotou Central Hospital

Baotou, Inner Mongolia, China

Site Status RECRUITING

Inner Mongolia Autonomous Region People's Hospital

Hohhot, Inner Mongolia, China

Site Status RECRUITING

Tongliao City Hospital

Tongliao, Inner Mongolia, China

Site Status RECRUITING

Wuhai People's Hospital

Wuhai, Inner Mongolia, China

Site Status RECRUITING

The Second Affiliated Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status RECRUITING

The Second Norman Bethune Hospital of JilinUniversity,

Changchun, Jilin, China

Site Status RECRUITING

General Hospital of Benxi Iron and Steel Co

Benxi, Liaoning, China

Site Status RECRUITING

Shanxi Cardiovascular Hospital

Taiyuan, Shanxi, China

Site Status RECRUITING

Shanxi Provincial People's Hospital

Taiyuan, Shanxi, China

Site Status RECRUITING

The First Affiliated Hospital of College of Medicine

Hangzhou, Zhejiang, China

Site Status RECRUITING

Lishui People's Hospital

Lishui, Zhejiang, China

Site Status RECRUITING

Beilun People's Hospital of Ningbo City

Ningbo, Zhejiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Ning Ma, MD

Role: CONTACT

Phone: 13581889908

Email: [email protected]

Baixue Jia, MD

Role: CONTACT

Phone: 15010125093

Email: [email protected]

Facility Contacts

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Zhongrong Miao, MD

Role: primary

Jinglin Yuan

Role: primary

Jinglin Yuan

Role: backup

Dong Sun

Role: primary

Dong Sun

Role: backup

Chengjing Xue

Role: primary

Chengjing Xue

Role: backup

Yingyi Li

Role: primary

Yingyi Li

Role: backup

Wanming Wang

Role: primary

Wanming Wang

Role: backup

Changchun Jiang

Role: primary

Changchun Jiang

Role: backup

Rile Wu

Role: primary

Rile Wu

Role: backup

Peng Xu

Role: primary

Peng Xu

Role: backup

Hu Shen

Role: primary

Hu Shen

Role: backup

Guibing Ding

Role: primary

Guibing Ding

Role: backup

Long Yan

Role: primary

Long Yan

Role: backup

Qian Wang

Role: primary

Dong Kuai

Role: primary

Dong Kuai

Role: backup

Yaxuan Sun

Role: primary

Yaxuan Sun

Role: backup

Ziqi Xu

Role: primary

Ziqi Xu

Role: backup

Lin Xiang

Role: primary

Lin Xiang

Role: backup

Xing Fang

Role: primary

Xing Fang

Role: backup

References

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Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y, Liu J, Zhang M, Qi J, Yu S, Afshin A, Gakidou E, Glenn S, Krish VS, Miller-Petrie MK, Mountjoy-Venning WC, Mullany EC, Redford SB, Liu H, Naghavi M, Hay SI, Wang L, Murray CJL, Liang X. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 Sep 28;394(10204):1145-1158. doi: 10.1016/S0140-6736(19)30427-1. Epub 2019 Jun 24.

Reference Type BACKGROUND
PMID: 31248666 (View on PubMed)

GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):439-458. doi: 10.1016/S1474-4422(19)30034-1. Epub 2019 Mar 11.

Reference Type BACKGROUND
PMID: 30871944 (View on PubMed)

Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Kasner SE, Benesch CG, Sila CA, Jovin TG, Romano JG; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med. 2005 Mar 31;352(13):1305-16. doi: 10.1056/NEJMoa043033.

Reference Type BACKGROUND
PMID: 15800226 (View on PubMed)

Chimowitz MI, Lynn MJ, Derdeyn CP, Turan TN, Fiorella D, Lane BF, Janis LS, Lutsep HL, Barnwell SL, Waters MF, Hoh BL, Hourihane JM, Levy EI, Alexandrov AV, Harrigan MR, Chiu D, Klucznik RP, Clark JM, McDougall CG, Johnson MD, Pride GL Jr, Torbey MT, Zaidat OO, Rumboldt Z, Cloft HJ; SAMMPRIS Trial Investigators. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med. 2011 Sep 15;365(11):993-1003. doi: 10.1056/NEJMoa1105335. Epub 2011 Sep 7.

Reference Type BACKGROUND
PMID: 21899409 (View on PubMed)

Shin YS, Kim BM, Suh SH, Jeon P, Kim DJ, Kim DI, Kim BS, Kim KH, Heo JH, Nam HS, Kim YD. Wingspan stenting for intracranial atherosclerotic stenosis: clinical outcomes and risk factors for in-stent restenosis. Neurosurgery. 2013 Apr;72(4):596-604; discussion 604. doi: 10.1227/NEU.0b013e3182846e09.

Reference Type BACKGROUND
PMID: 23277374 (View on PubMed)

Jin M, Fu X, Wei Y, Du B, Xu XT, Jiang WJ. Higher risk of recurrent ischemic events in patients with intracranial in-stent restenosis. Stroke. 2013 Nov;44(11):2990-4. doi: 10.1161/STROKEAHA.113.001824. Epub 2013 Aug 20.

Reference Type BACKGROUND
PMID: 23963335 (View on PubMed)

Lu WD, Huang CW, Li YH, Chen JY. Multiple Mechanisms in 1 In-Stent Restenosis Assessed by Optical Coherence Tomography. JACC Cardiovasc Interv. 2017 Nov 27;10(22):2340-2341. doi: 10.1016/j.jcin.2017.07.017. Epub 2017 Nov 1. No abstract available.

Reference Type BACKGROUND
PMID: 29102578 (View on PubMed)

Other Identifiers

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HX-A-018(2021)

Identifier Type: -

Identifier Source: org_study_id