Ischemic Stroke Clinical Trial
Official title:
Comparison of Thrombectomy and Standard Care for Ischemic Stroke in Patients Ineligibility for Tissue Plasminogen Activator Treatment
the purpose of this study is to to compare the safety and effectiveness of stent-retrievers as a device class group with best medical care alone in the treatment of acute ischemic stroke (AIS) in patients who are not eligible for IV-tPA up to 8 hours of symptom onset.
This is a prospective, binational (Germany and Austria), two-arm, randomized, controlled,
open label, blinded endpoint post-market study to compare the safety and effectiveness of
stent retrievers for thrombectomy compared to best medical treatment alone in acute ischemic
stroke (AIS) patients not eligible for IV-tPA treatment.
Patients who meet the inclusion criteria will be randomized to one of the following two
treatment arms:
- best medical care alone or
- best medical care plus endovascular thrombectomy with stent retriever (referred to as
thrombectomy).
Endpoints in this prospective open label study will be assessed blinded to the treatment
assignment of the patient (PROBE design). This study will be conducted in up to 20 centers in
Germany and Austria. This is an adaptive design study, in which there are prospectively
stated interim analyses with specified stopping rules, which allow for the possibility of the
study to terminate early based on either a determination of study success or of the futility
to continue further enrollment.
Up to six hundred (600) subjects, 300 per treatment group, will be enrolled and randomized in
the study for the Intent to Treat (ITT) analysis set. The randomization will be stratified by
time from symptom onset and stroke severity (NIHSS). The expected duration of each subject‟s
enrollment is approximately 90 days. Subjects will be followed with assessments at 30 (+/-6)
hours, hospital discharge, and 90 (+/-14) days post stroke.
A blinded core laboratory will assess baseline imaging to confirm vessel occlusion and
determine ASPECT score, 30 (+/- 6) hours post treatment imaging to assess presence of ICH,
and to measure core infarct volume.
The primary effectiveness endpoint for a subject is the blinded evaluation of the ordinal mRS
outcome at 90 days post-stroke. The primary effectiveness endpoint analysis is a chi-square
test of the difference in linear trends in mRS outcomes at 90 days post-stroke between
treatment groups ("mRS shift analysis").
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