Intracerebral Hemorrhage Clinical Trial
Official title:
Efficacy and Safety of Factor VIIa (Eptacog Alfa) on Rebleeding After Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage. A Randomized, Controlled, Open-Label, Investigator-Blinded Pilot Study
Although the role of surgical treatment is still controversial, surgical evacuation of
intracerebral hematoma is a frequent practice. Rebleeding is a frequent complication in
patients submitted to hematoma evacuation. It has been reported that smaller postoperative
volume of hematoma is associated with a better outcome. The investigators hypothesize that
the administration of Factor VIIa (Eptacog alfa) immediately after surgical evacuation of the
hematoma can reduce postoperative rebleeding.
Aims of the Study:
This study will investigate:
1. The efficacy of Eptacog alfa in preventing or reducing rebleeding after surgery for
spontaneous supratentorial ICH; and
2. The safety of product administration
The primary endpoint is the evaluation of efficacy of Factor VIIa (Eptacog alfa, NovoSeven,
Novo Nordisk) on rebleeding after surgery for primary supratentorial ICH. All patients
included in the study will perform a CT scan within 3 hours before surgery, then immediately
after surgery, and 18-30 hours after surgery. The hematoma volume will be evaluated by a
multi-slice CT scan. All CT scan images will be sent to the Coordinating Center where the
hematoma volume will be evaluated by a dedicated software by the same investigator who will
be unaware of the treatment (investigator- blinded study).
SAFETY EVALUATION:
Seventeen episodes of thrombotic spontaneous adverse events have been reported after
administration of 480,000 standard doses of Eptacog alfa in hemophilic patients. These
episodes include myocardial infarction, acute cerebrovascular thrombosis, disseminated
intravascular coagulation (DIC), deep venous thrombosis (DVT) and pulmonary embolism.
Before and after hematoma removal will be evaluated ECG, myocardiac enzymes, coagulation
profile, CT scan (looking for ischemic events) and venous echodoppler ultrasound of lower
extremities.
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