Clinical trial NCT02982200: Medina Embolization Device In Neurovascular Aneurysm Study
Official title: The MEDINA Study: Medina Embolization Device In Neurovascular Aneurysms Study - A Post Market Clinical Follow-up Study
Study type: OBSERVATIONAL
Overall status: TERMINATED
Conditions: Intracranial Aneurysm
Keywords: Embolization Device
Medina
Rupture Intracranial Aneurysm
Unrupture Intracranial Aneurysm
Lead sponsor: Medtronic Neurovascular Clinical Affairs
Sponsor class: INDUSTRY
Collaborators: name: Medtronic Cardiac Rhythm and Heart Failure
First posted: 2016-12-05
Enrollment: 15
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Saccular intracranial aneurysm not previously treated.

Brief summary: A global prospective, multi-center, single-arm, post-market clinical follow-up (PMCF) study conducted to assess the performance of the Medina Embolization Device when used in unruptured and ruptured intracranial aneurysms.


Eligibility criteria: Inclusion Criteria:

* Subject has provided written informed consent using the Ethics Committee-approved consent form and agrees to comply with protocol requirements
* Subject is 18- 85 years old
* Subject has a ruptured or unruptured saccular intra-cranial aneurysm amenable to be treated with the Medina Embolization Device

Exclusion Criteria:

* Aneurysm is partially thrombosed
* Aneurysm has been previously treated with surgery or endovascular therapy
* Subject has had major brain surgery including endovascular procedures within the past 30 days
* Vessel characteristics (tortuosity, stenosis, morphology) preclude safe endovascular access to the aneurysm
* Subject is pregnant or breast-feeding or wishes to become pregnant during the length of the study participation
* The Investigator determines that the validity of the study outcomes may be compromised by the subject's enrollment

Primary outcomes:
measure: Complete aneurysm occlusion as defined by the Modified Raymond-Roy Classification (MRRC)
timeFrame: 12 months
Secondary outcomes:
Other outcomes:
Locations:
city: Salzburg
country: Austria
facility: Universitätsklinikum Christian Doppler Klinik Salzburg
city: Milan
country: Italy
facility: Azienda Ospedaliera Ospedale Niguarda Cà Granda
city: Madrid
country: Spain
facility: Hospital Fundación Jiménez Díaz
Study officials:
affiliation: Karolinska University Hospital
name: Patrick Brouwer, Dr
role: STUDY_CHAIR
References:
citation: Inagawa T, Hirano A. Autopsy study of unruptured incidental intracranial aneurysms. Surg Neurol. 1990 Dec;34(6):361-5. doi: 10.1016/0090-3019(90)90237-j.
citation: Agarwal N, Gala NB, Choudhry OJ, Assina R, Prestigiacomo CJ, Duffis EJ, Gandhi CD. Prevalence of asymptomatic incidental aneurysms: a review of 2,685 computed tomographic angiograms. World Neurosurg. 2014 Dec;82(6):1086-90. doi: 10.1016/j.wneu.2013.01.082. Epub 2013 Jan 19.
citation: Winn HR, Jane JA Sr, Taylor J, Kaiser D, Britz GW. Prevalence of asymptomatic incidental aneurysms: review of 4568 arteriograms. J Neurosurg. 2002 Jan;96(1):43-9. doi: 10.3171/jns.2002.96.1.0043.
citation: Schievink WI. Intracranial aneurysms. N Engl J Med. 1997 Jan 2;336(1):28-40. doi: 10.1056/NEJM199701023360106. No abstract available.
citation: Bonneville F, Sourour N, Biondi A. Intracranial aneurysms: an overview. Neuroimaging Clin N Am. 2006 Aug;16(3):371-82, vii. doi: 10.1016/j.nic.2006.05.001.
citation: Gemmete JJ, Elias AE, Chaudhary N, Pandey AS. Endovascular methods for the treatment of intracranial cerebral aneurysms. Neuroimaging Clin N Am. 2013 Nov;23(4):563-91. doi: 10.1016/j.nic.2013.03.007. Epub 2013 May 25.
citation: Wiebers DO, Whisnant JP, Huston J 3rd, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O'Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003 Jul 12;362(9378):103-10. doi: 10.1016/s0140-6736(03)13860-3.
citation: UCAS Japan Investigators; Morita A, Kirino T, Hashi K, Aoki N, Fukuhara S, Hashimoto N, Nakayama T, Sakai M, Teramoto A, Tominari S, Yoshimoto T. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med. 2012 Jun 28;366(26):2474-82. doi: 10.1056/NEJMoa1113260.
citation: Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001 Sep;32(9):1998-2004. doi: 10.1161/hs0901.095600.
citation: Zuccarello M. Treatment strategy for patients with unruptured intracranial aneurysms. Neurol Med Chir (Tokyo). 2001 Dec;41(12):571-5. doi: 10.2176/nmc.41.571.
citation: Broderick JP, Brott TG, Duldner JE, Tomsick T, Leach A. Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. Stroke. 1994 Jul;25(7):1342-7. doi: 10.1161/01.str.25.7.1342.
citation: Johnston SC, Higashida RT, Barrow DL, Caplan LR, Dion JE, Hademenos G, Hopkins LN, Molyneux A, Rosenwasser RH, Vinuela F, Wilson CB; Committee on Cerebrovascular Imaging of the American Heart Association Council on Cardiovascular Radiology. Recommendations for the endovascular treatment of intracranial aneurysms: a statement for healthcare professionals from the Committee on Cerebrovascular Imaging of the American Heart Association Council on Cardiovascular Radiology. Stroke. 2002 Oct;33(10):2536-44. doi: 10.1161/01.str.0000034708.66191.7d. No abstract available.
citation: Raaymakers TW, Rinkel GJ, Limburg M, Algra A. Mortality and morbidity of surgery for unruptured intracranial aneurysms: a meta-analysis. Stroke. 1998 Aug;29(8):1531-8. doi: 10.1161/01.str.29.8.1531.
citation: Lanzino G, Murad MH, d'Urso PI, Rabinstein AA. Coil embolization versus clipping for ruptured intracranial aneurysms: a meta-analysis of prospective controlled published studies. AJNR Am J Neuroradiol. 2013 Sep;34(9):1764-8. doi: 10.3174/ajnr.A3515. Epub 2013 Apr 11.
citation: Vanninen R, Koivisto T, Saari T, Hernesniemi J, Vapalahti M. Ruptured intracranial aneurysms: acute endovascular treatment with electrolytically detachable coils--a prospective randomized study. Radiology. 1999 May;211(2):325-36. doi: 10.1148/radiology.211.2.r99ap06325.
citation: McDougall CG, Spetzler RF, Zabramski JM, Partovi S, Hills NK, Nakaji P, Albuquerque FC. The Barrow Ruptured Aneurysm Trial. J Neurosurg. 2012 Jan;116(1):135-44. doi: 10.3171/2011.8.JNS101767. Epub 2011 Nov 4.
citation: Molyneux A, Kerr R; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group; Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial. J Stroke Cerebrovasc Dis. 2002 Nov-Dec;11(6):304-14. doi: 10.1053/jscd.2002.130390.
citation: Seibert B, Tummala RP, Chow R, Faridar A, Mousavi SA, Divani AA. Intracranial aneurysms: review of current treatment options and outcomes. Front Neurol. 2011 Jul 8;2:45. doi: 10.3389/fneur.2011.00045. eCollection 2011.
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.
citation: Miller TR, Jindal G, Krejza J, Gandhi D. Impact of Endovascular Technique on Fluoroscopy Usage: Stent-Assisted Coiling versus Flow Diversion for Paraclinoid Internal Carotid Artery Aneurysms. Neuroradiol J. 2014 Dec;27(6):725-31. doi: 10.15274/NRJ-2014-10094. Epub 2014 Dec 1.
citation: Crobeddu E, Lanzino G, Kallmes DF, Cloft HJ. Review of 2 decades of aneurysm-recurrence literature, part 2: Managing recurrence after endovascular coiling. AJNR Am J Neuroradiol. 2013 Mar;34(3):481-5. doi: 10.3174/ajnr.A2958. Epub 2012 Mar 15.
citation: Sekhar LN, Heros RC. Origin, growth, and rupture of saccular aneurysms: a review. Neurosurgery. 1981 Feb;8(2):248-60. doi: 10.1227/00006123-198102000-00020.
citation: Abdihalim M, Watanabe M, Chaudhry SA, Jagadeesan B, Suri MF, Qureshi AI. Are coil compaction and aneurysmal growth two distinct etiologies leading to recurrence following endovascular treatment of intracranial aneurysm? J Neuroimaging. 2014 Mar-Apr;24(2):171-5. doi: 10.1111/j.1552-6569.2012.00786.x. Epub 2013 Jan 14.
citation: Mori K, Nakao Y, Horinaka N, Wada R, Hirano A, Maeda M. Cerebral aneurysm regrowth and coil unraveling after incomplete Guglielmi detachable coil embolization: serial angiographical and histological findings. Neurol Med Chir (Tokyo). 2003 Jun;43(6):293-7. doi: 10.2176/nmc.43.293.
citation: Sedat J, Chau Y, Litrico S, Rasandrarijao D, Lonjon M, Paquis P. Stretched platinum coil during cerebral aneurysm embolization after direct carotid puncture: two case reports. Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6):1248-51. doi: 10.1007/s00270-007-9058-x. Epub 2007 May 17.
citation: Mascitelli JR, Moyle H, Oermann EK, Polykarpou MF, Patel AA, Doshi AH, Gologorsky Y, Bederson JB, Patel AB. An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg. 2015 Jul;7(7):496-502. doi: 10.1136/neurintsurg-2014-011258. Epub 2014 Jun 4.
citation: Rouchaud A, Brinjikji W, Gunderson T, Caroff J, Gentric JC, Lanzino G, Cloft HJ, Kallmes DF. Validity of the Meyer Scale for Assessment of Coiled Aneurysms and Aneurysm Recurrence. AJNR Am J Neuroradiol. 2016 May;37(5):844-8. doi: 10.3174/ajnr.A4616. Epub 2015 Nov 12.
citation: McDougall CG, Johnston SC, Gholkar A, Barnwell SL, Vazquez Suarez JC, Masso Romero J, Chaloupka JC, Bonafe A, Wakhloo AK, Tampieri D, Dowd CF, Fox AJ, Imm SJ, Carroll K, Turk AS; MAPS Investigators. Bioactive versus bare platinum coils in the treatment of intracranial aneurysms: the MAPS (Matrix and Platinum Science) trial. AJNR Am J Neuroradiol. 2014 May;35(5):935-42. doi: 10.3174/ajnr.A3857. Epub 2014 Jan 30.
citation: Pierot L, Delcourt C, Bouquigny F, Breidt D, Feuillet B, Lanoix O, Gallas S. Follow-up of intracranial aneurysms selectively treated with coils: Prospective evaluation of contrast-enhanced MR angiography. AJNR Am J Neuroradiol. 2006 Apr;27(4):744-9.
citation: Pierot L, Cognard C, Anxionnat R, Ricolfi F; CLARITY Investigators. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY). AJNR Am J Neuroradiol. 2012 Sep;33(8):1475-80. doi: 10.3174/ajnr.A3003. Epub 2012 Apr 19.