Early Versus Ultra Early Surgical Treatment of Ruptured Intracranial Aneurysms

NCT ID: NCT06457347

Last Updated: 2024-06-13

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-01

Study Completion Date

2026-06-30

Brief Summary

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The goal of this clinical trial is to determine the most effective timing for clipping in adults with ruptured intracranial aneurysms. It will also assess the safety of performing the surgery at different times of early period after the aneurysm has ruptured. The main questions it aims to answer are:

1. Does ultra-early surgical intervention ( less than 24 hours of rupture) improve survival rates compared to delayed surgery (24 to 72 hours after rupture)?
2. What are the complication rates associated with early versus delayed surgical intervention?

Researchers will compare clipping in ultra-early period to surgery in early period to see if timing affects the outcomes for treating ruptured intracranial aneurysms.

Participants will:

* Be randomly assigned to undergo surgical clipping either within 24 hours of rupture or between 24 hours to 72 hours after the rupture.
* Visit the clinic for follow-up assessments at 1 month, 3 months, 6 months, and 12 months post-surgery.
* Keep a diary of their symptoms, neurological function, and any complications they experience post-surgery.

Detailed Description

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Conditions

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Aneurysmal Subarachnoid Hemorrhage

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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Ultra early (<24 hours)

Group Type EXPERIMENTAL

Ultra early (<24 hours) ruptured aneurysm clipping

Intervention Type PROCEDURE

Aneurysms are clipped with open surgery in less than 24 hours after rupture to prevent early rebleeding.

Early (24-72 hours)

Group Type ACTIVE_COMPARATOR

Early (24-72 hours) ruptured aneurysm clipping

Intervention Type PROCEDURE

Aneurysms are clipped with open surgery in 24 to 72 hours after rupture to prevent early rebleeding.

Interventions

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Ultra early (<24 hours) ruptured aneurysm clipping

Aneurysms are clipped with open surgery in less than 24 hours after rupture to prevent early rebleeding.

Intervention Type PROCEDURE

Early (24-72 hours) ruptured aneurysm clipping

Aneurysms are clipped with open surgery in 24 to 72 hours after rupture to prevent early rebleeding.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* aneurysmal subarachnoid hemorrhage
* patient eligible for surgical clipping
* patients with informed consent for inclusion into the study

Exclusion Criteria

* patients admitted and treated \>72 h after subarachnoid hemorrhage onset
* patients with severe comorbidities
* patients with multiple aneurysms
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Revaz Dzhindzhikhadze

OTHER_GOV

Sponsor Role lead

Responsible Party

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Revaz Dzhindzhikhadze

Chief of neurosurgical department

Responsibility Role SPONSOR_INVESTIGATOR

Central Contacts

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Revaz Dzhindzhikhadze, PhD

Role: CONTACT

+79161519868

Vadim Gadzhiagaev, MD

Role: CONTACT

+7-999-528-84-10

References

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Phillips TJ, Dowling RJ, Yan B, Laidlaw JD, Mitchell PJ. Does treatment of ruptured intracranial aneurysms within 24 hours improve clinical outcome? Stroke. 2011 Jul;42(7):1936-45. doi: 10.1161/STROKEAHA.110.602888. Epub 2011 Jun 16.

Reference Type BACKGROUND
PMID: 21680909 (View on PubMed)

Tan H, Huang G, Li Z, Feng H, Wang Z, Zhao D, Tang J, Liu J. The impact of surgical timing on the management of aneurysms with acute hydrocephalus after aneurysmal subarachnoid hemorrhage. Turk Neurosurg. 2014;24(3):385-90. doi: 10.5137/1019-5149.JTN.9484-13.0.

Reference Type BACKGROUND
PMID: 24848179 (View on PubMed)

Oudshoorn SC, Rinkel GJ, Molyneux AJ, Kerr RS, Dorhout Mees SM, Backes D, Algra A, Vergouwen MD. Aneurysm treatment <24 versus 24-72 h after subarachnoid hemorrhage. Neurocrit Care. 2014 Aug;21(1):4-13. doi: 10.1007/s12028-014-9969-8.

Reference Type BACKGROUND
PMID: 24639201 (View on PubMed)

Dalbayrak S, Altas M, Arslan R. The effects of timing of aneurysm surgery on vasospasm and mortality in patients with subarachnoid hemorrhage. Acta Neurol Belg. 2011 Dec;111(4):317-20.

Reference Type BACKGROUND
PMID: 22368972 (View on PubMed)

Ross N, Hutchinson PJ, Seeley H, Kirkpatrick PJ. Timing of surgery for supratentorial aneurysmal subarachnoid haemorrhage: report of a prospective study. J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):480-4. doi: 10.1136/jnnp.72.4.480.

Reference Type BACKGROUND
PMID: 11909907 (View on PubMed)

Dorhout Mees SM, Molyneux AJ, Kerr RS, Algra A, Rinkel GJ. Timing of aneurysm treatment after subarachnoid hemorrhage: relationship with delayed cerebral ischemia and poor outcome. Stroke. 2012 Aug;43(8):2126-9. doi: 10.1161/STROKEAHA.111.639690. Epub 2012 Jun 14.

Reference Type BACKGROUND
PMID: 22700527 (View on PubMed)

Other Identifiers

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sah_moniki

Identifier Type: -

Identifier Source: org_study_id

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