Conditions: Ischemic Stroke Transient Ischemic Attack
Keywords: Ischemic stroke Transient Ischemic Attack Intracranial Stenting
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 125
Healthy volunteers: no

Brief summary:
The main objective of this study is to prospectively evaluate the safety, probable benefit, and effectiveness of the PHAROS Vitesse Neurovascular Stent System in a multicenter, randomized clinical trial.

A secondary objective of this study is to evaluate the impact of stenting in the neurovasculature to treat cerebral ischemia on other outcomes such as hospital length of stay, charges, and costs.

Detailed description:
1.1 Study Hypothesis Treatment of cerebral or retinal ischemia due to plaque in the neurovasculature using the PHAROS Vitesse Stent System plus medical therapy will provide additional clinical benefit over medical therapy alone.

1.2 Primary Effectiveness Endpoint

The primary effectiveness endpoint consists of a composite of the two following outcomes:

* Stroke in the same territory (distal to the target lesion) as the presenting event within 12 months of randomization
* Hard TIA in the same territory (distal to the target lesion) as the presenting event from day 2 through month 12 post-randomization

1.3 Safety Outcomes

Safety outcomes to be collected and reported as part of the overall risk-to-benefit profile for this device are:

* Stroke in any territory within 30 days of randomization
* Death from any cause within 30 days of randomization
* Hard TIA in any territory occurring after a 24 hour post-procedure stabilization period (days 2-30) since the recovery from anesthesia can mask accurate assessment of possible TIA symptoms.
* Intracranial hemorrhage within 30 days of randomization

1.4 Other Outcomes

* Stent Success - PHAROS Vitesse stent deployed across target lesion with residual stenosis 0-20%
* Percentage of Stent Group Subjects with any (symptomatic or asymptomatic) in-stent restenosis ≥ 70% confirmed by angiogram at 12 months
* Percentage of Stent Group Subjects with symptomatic in-stent restenosis ≥ 70% confirmed by angiogram at 12 months
* Percentage of Medical Therapy Group Subjects with interventional procedure (e.g., angioplasty or stent) at 12 months
* Comparison of NIHSS scores between treatment arms
* Comparison of mRS scores between treatment arms

Arms:
arm 1: Medical therapy + PHAROS Vitesse neurovascular stent ("Stent Group") arm 2: Medical therapy alone ("Medical Therapy Group")

Interventions: intervention 1: Pharos Vitesse Neurovascular Stent System (Stent implantation) + Medical therapy (Aspirin and Clopidogrel) intervention 2: Aspirin and Clopidogrel (Medical therapy)
Intervention descriptions: intervention 1: Implantation of one or more balloon-expandable Pharos Vitesse stents to treat neurovascular ischemic lesions + Medical therapy \[Treatment with aspirin (81-325 mg daily for the duration of the study) and Clopidogrel (75 mg daily for first 3 months)\] intervention 2: Medical therapy alone \[Treatment with aspirin (81-325 mg daily for the duration of the study) and Clopidogrel (75 mg daily for first 3 months)\]

Protocol document: