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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01444664
Other study ID # 20137
Secondary ID
Status Completed
Phase Phase 4
First received August 30, 2011
Last updated March 23, 2016
Start date June 2010
Est. completion date June 2015

Study information

Verified date April 2015
Source Medical University of South Carolina
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

The purpose of this prospective registry is to determine if patients harboring intracranial aneurysms have any predictive markers between aneurysm wall tissue, cerebrospinal fluid and blood plasma.


Description:

To design a registry to evaluate the wall of intracranial aneurysms during open surgical clipping by direct photographic appearance, wall biopsy samples, CSF and blood plasma fluid collection (Interleukins; IL-8/ Matrix Metalloproteinase; MMP-9) for complete evaluation and comparison.

The focus of the registry will be to determine the presence of aneurysmal wall defects, mural clot, atherosclerotic and atheroma, wall permeability and delamination. These findings will then be correlated to the collected CSF and blood values to determine if there is any direct features of the aneurysm wall that would predict any of the reported post embolic syndromes. The collected data can also be correlated to the peroperative imaging, (MRI, CT and Angiogram).


Recruitment information / eligibility

Status Completed
Enrollment 24
Est. completion date June 2015
Est. primary completion date June 2015
Accepts healthy volunteers No
Gender Both
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria:

- Patient > 18 years but < 80 years of age

- Patient with an unruptured Intracranial aneurysm 8mm or larger

- Patient that surgical exposure and clipping will be the primary treatment option

Exclusion Criteria:

- Any patient that has a ruptured intracranial aneurysm

- Any Pediatric patients

- Any patient presenting with any pre-treatment intracranial lesions

- Vascular malformations

- Hemorrhage

- Normal Pressure Hydrocephalus

- Obstructive Hydrocephalus

- White matter disease

- Tumors

- Trauma

- Other vascular type lesions

- Any meningitis type symptoms

- Medical or surgical co-morbidities such that the patient's life expectancy is less than 1 year

- Inability to obtain consent

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Procedure:
Surgical Clipping of Aneurysm
Surgical clipping of intracranial aneurysm

Locations

Country Name City State
Canada Royal University Hospital Saskatoon Ontario
United States Albany Medical Center Albany New York
United States Medical University of South Carolina Charleston South Carolina
United States Northwestern University Chicago Illinois
United States University Of Illinois Chicago Illinois
United States Goodman Campbell Indianapolis Indiana
United States Methodist Healthcare - Memphis Memphis Tennessee
United States Vanderbilt University Nashville Tennessee
United States Providence Health Portland Oregon
United States SUNY - Stonybrook University Medical Center Stonybrook New York

Sponsors (10)

Lead Sponsor Collaborator
Medical University of South Carolina Albany Medical College, Indiana University, Methodist Health System, Northwestern University, Providence Health & Services, Royal University Hospital Foundation, Stony Brook University, University of Illinois at Chicago, Vanderbilt University

Countries where clinical trial is conducted

United States,  Canada, 

References & Publications (35)

Aydin F. Do human intracranial arteries lack vasa vasorum? A comparative immunohistochemical study of intracranial and systemic arteries. Acta Neuropathol. 1998 Jul;96(1):22-8. — View Citation

Bendszus M, Solymosi L. Cerecyte coils in the treatment of intracranial aneurysms: a preliminary clinical study. AJNR Am J Neuroradiol. 2006 Nov-Dec;27(10):2053-7. — View Citation

Berenstein A, Song JK, Niimi Y, Namba K, Heran NS, Brisman JL, Nahoum MC, Madrid M, Langer DJ, Kupersmith MJ. Treatment of cerebral aneurysms with hydrogel-coated platinum coils (HydroCoil): early single-center experience. AJNR Am J Neuroradiol. 2006 Oct;27(9):1834-40. — View Citation

Brisman JL, Song JK, Newell DW. Cerebral aneurysms. N Engl J Med. 2006 Aug 31;355(9):928-39. Review. — View Citation

Bruno G, Todor R, Lewis I, Chyatte D. Vascular extracellular matrix remodeling in cerebral aneurysms. J Neurosurg. 1998 Sep;89(3):431-40. — View Citation

Chyatte D, Bruno G, Desai S, Todor DR. Inflammation and intracranial aneurysms. Neurosurgery. 1999 Nov;45(5):1137-46; discussion 1146-7. — View Citation

Deshaies EM, Adamo MA, Boulos AS. A prospective single-center analysis of the safety and efficacy of the hydrocoil embolization system for the treatment of intracranial aneurysms. J Neurosurg. 2007 Feb;106(2):226-33. — View Citation

Fanning NF, Willinsky RA, ter Brugge KG. Wall enhancement, edema, and hydrocephalus after endovascular coil occlusion of intradural cerebral aneurysms. J Neurosurg. 2008 Jun;108(6):1074-86. doi: 10.3171/JNS/2008/108/6/1074. — View Citation

Hara A, Yoshimi N, Mori H. Evidence for apoptosis in human intracranial aneurysms. Neurol Res. 1998 Mar;20(2):127-30. — View Citation

Horie N, Kitagawa N, Morikawa M, Tsutsumi K, Kaminogo M, Nagata I. Progressive perianeurysmal edema induced after endovascular coil embolization. Report of three cases and review of the literature. J Neurosurg. 2007 May;106(5):916-20. Review. — View Citation

Im SH, Han MH, Kwon BJ, Jung C, Kim JE, Han DH. Aseptic meningitis after embolization of cerebral aneurysms using hydrogel-coated coils: report of three cases. AJNR Am J Neuroradiol. 2007 Mar;28(3):511-2. — View Citation

Im SH, Han MH, Kwon OK, Kwon BJ, Kim SH, Kim JE, Oh CW. Endovascular coil embolization of 435 small asymptomatic unruptured intracranial aneurysms: procedural morbidity and patient outcome. AJNR Am J Neuroradiol. 2009 Jan;30(1):79-84. doi: 10.3174/ajnr.A1290. Epub 2008 Sep 3. — View Citation

Juvela S, Hillbom M, Numminen H, Koskinen P. Cigarette smoking and alcohol consumption as risk factors for aneurysmal subarachnoid hemorrhage. Stroke. 1993 May;24(5):639-46. — View Citation

Juvela S. Prehemorrhage risk factors for fatal intracranial aneurysm rupture. Stroke. 2003 Aug;34(8):1852-7. Epub 2003 Jun 26. — View Citation

Kang HS, Han MH, Lee TH, Shin YS, Roh HG, Kwon OK, Kwon BJ, Kim SY, Kim SH, Byun HS. Embolization of intracranial aneurysms with hydrogel-coated coils: result of a Korean multicenter trial. Neurosurgery. 2007 Jul;61(1):51-8; discussion 58-9. — View Citation

Kataoka K, Taneda M, Asai T, Kinoshita A, Ito M, Kuroda R. Structural fragility and inflammatory response of ruptured cerebral aneurysms. A comparative study between ruptured and unruptured cerebral aneurysms. Stroke. 1999 Jul;30(7):1396-401. — View Citation

Killer M, Baltsavias G, Huemer M, Richling B. Visual worsening after incomplete coiling of a small asymptomatic aneurysm: case report and review of the literature. Minim Invasive Neurosurg. 2009 Feb;52(1):39-43. doi: 10.1055/s-0028-1104565. Epub 2009 Feb 26. Review. — View Citation

Kosierkiewicz TA, Factor SM, Dickson DW. Immunocytochemical studies of atherosclerotic lesions of cerebral berry aneurysms. J Neuropathol Exp Neurol. 1994 Jul;53(4):399-406. — View Citation

Krex D, Schackert HK, Schackert G. Genesis of cerebral aneurysms--an update. Acta Neurochir (Wien). 2001;143(5):429-48; discussion 448-9. Review. — View Citation

Marchan EM, Sekula RF Jr, Ku A, Williams R, O'Neill BR, Wilberger JE, Quigley MR. Hydrogel coil-related delayed hydrocephalus in patients with unruptured aneurysms. J Neurosurg. 2008 Aug;109(2):186-90. doi: 10.3171/JNS/2008/109/8/0186. — View Citation

Marden FA, Putman CM. Perianeurysm edema with second-generation bioactive coils. Surg Neurol. 2008 Jun;69(6):627-32; discussion 632. Epub 2007 Oct 31. — View Citation

Meyers PM, Lavine SD, Fitzsimmons BF, Commichau C, Parra A, Mayer SA, Solomon RA, Connolly ES Jr. Chemical meningitis after cerebral aneurysm treatment using two second-generation aneurysm coils: report of two cases. Neurosurgery. 2004 Nov;55(5):1222. — View Citation

Nakajima N, Nagahiro S, Sano T, Satomi J, Satoh K. Phenotypic modulation of smooth muscle cells in human cerebral aneurysmal walls. Acta Neuropathol. 2000 Nov;100(5):475-80. — View Citation

Nishino K, Ito Y, Hasegawa H, Shimbo J, Kikuchi B, Fujii Y. Development of cranial nerve palsy shortly after endosaccular embolization for asymptomatic cerebral aneurysm: report of two cases and literature review. Acta Neurochir (Wien). 2009 Apr;151(4):379-83. doi: 10.1007/s00701-009-0234-4. Epub 2009 Mar 5. — View Citation

Pickett GE, Laitt RD, Herwadkar A, Hughes DG. Visual pathway compromise after hydrocoil treatment of large ophthalmic aneurysms. Neurosurgery. 2007 Oct;61(4):E873-4; discussion E874. — View Citation

Ronkainen A, Hernesniemi J. Subarachnoid haemorrhage of unknown aetiology. Acta Neurochir (Wien). 1992;119(1-4):29-34. — View Citation

Sahs AL. Observations on the pathology of saccular aneurysms. J Neurosurg. 1966 Apr;24(4):792-806. — View Citation

Scanarini M, Mingrino S, Giordano R, Baroni A. Histological and ultrastructural study of intracranial saccular aneurysmal wall. Acta Neurochir (Wien). 1978;43(3-4):171-82. — View Citation

Schmidt GW, Oster SF, Golnik KC, Tumialán LM, Biousse V, Turbin R, Prestigiacomo CJ, Miller NR. Isolated progressive visual loss after coiling of paraclinoid aneurysms. AJNR Am J Neuroradiol. 2007 Nov-Dec;28(10):1882-9. — View Citation

STEHBENS WE. ANEURYSMS AND ANATOMICAL VARIATION OF CEREBRAL ARTERIES. Arch Pathol. 1963 Jan;75:45-64. — View Citation

Stracke CP, Krings T, Möller-Hartmann W, Mahdavi A, Klug N. Severe inflammatory reaction of the optic system after endovascular treatment of a supraophthalmic aneurysm with bioactive coils. AJNR Am J Neuroradiol. 2007 Aug;28(7):1401-2. — View Citation

Turner RD, Byrne JV, Kelly ME, Mitsos AP, Gonugunta V, Lalloo S, Rasmussen PA, Fiorella D. Delayed visual deficits and monocular blindness after endovascular treatment of large and giant paraophthalmic aneurysms. Neurosurgery. 2008 Sep;63(3):469-74; discussion 474-5. doi: 10.1227/01.NEU.0000324730.37144.4B. — View Citation

Ushikoshi S, Kikuchi Y, Houkin K, Miyasaka K, Abe H. Aggravation of brainstem symptoms caused by a large superior cerebellar artery aneurysm after embolization by Guglielmi detachable coils--case report. Neurol Med Chir (Tokyo). 1999 Jul;39(7):524-9. — View Citation

Weir B. Unruptured intracranial aneurysms: a review. J Neurosurg. 2002 Jan;96(1):3-42. Review. — View Citation

White JB, Cloft HJ, Kallmes DF. But did you use HydroCoil? Perianeurysmal edema and hydrocephalus with bare platinum coils. AJNR Am J Neuroradiol. 2008 Feb;29(2):299-300. Epub 2007 Nov 16. — View Citation

* Note: There are 35 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Histological Change To determine the relative and absolute differences in histological changes as seen in the tissue samples comparing this to the CSF and blood plasma samples. To also determine if there is any gene expressions that can be utilized as predictive markers in this cohort of patients. an average of 1 day after aneurysm treatment an analysis of the histological sample, CSF sample, and plasma samples will occur No
Secondary Treatment related morbidity and mortality Secondary analyses will be performed to compare treatment related morbidity and mortality, up to approximately 1 year post treatment Yes
Secondary Clinical Outcome clinical outcome at approximately 6 months after surgical clipping at routine follow up visit and approximately 12 months after clipping at routine follow up visit if indicated approximately clinical outcome at 6 months after surgical clipping at routine follow up visit and approximately 12 months after clipping at routine follow up visit if indicated No
Secondary Bleeding Rate bleeding rate post treatment. post treatment during approximate follow up periods 6mo and 12mo clinical follow up Yes
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