Treatment of Intracranial Aneurysms using vascular Reconstruction Assist device

ISRCTN ISRCTN13532658
DOI https://doi.org/10.1186/ISRCTN13532658
Secondary identifying numbers Version 3/08/2010
Submission date
02/02/2011
Registration date
07/04/2011
Last edited
05/04/2016
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
An intracranial aneurysm is a bulge in a blood vessel in the brain, caused by a weakness in the vessel wall. If it bursts (ruptures) this leads to bleeding and brain damage. Preventative surgery is recommended if there is a high risk of a rupture. Endovascular coiling involves inserting a thin tube into the aneurysm and passing tiny metal coils into the aneurysm to seal it off, preventing it from growing or rupturing. The aim of this study is to find out whether inserting a self-expanding tube (stent) into the aneurysm to assist coiling improves the outcome for the patient.

Who can participate?
Patients aged 18-70 with an intracranial aneurysm

What does the study involve?
Participants are randomly allocated to be treated with coiling either with or without stent assistance. Participants are assessed by angiography (a type of x-ray used to examine blood vessels) 12 months later to check for aneurysm recurrence.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Western General Hospital (UK)

When is the study starting and how long is it expected to run for?
June 2011 to June 2016

Who is funding the study?
Microvention Terumo Inc. (USA)

Who is the main contact?
Dr Philip White
pmw@skull.dcn.ed.ac.uk

Contact information

Dr Philip White
Scientific

DCN X-Ray
Western General Hospital
Crewe Road
Edinburgh
EH4 2XU
United Kingdom

Email pmw@skull.dcn.ed.ac.uk

Study information

Study designProspective multinational randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleTreatment of Intracranial Aneurysms using a vascular Reconstruction Assist device: a randomised controlled trial of self expanding stent (conventional mesh density) plus coiling versus coiling +/- temporary assist techniques
Study acronymTIARA
Study objectivesUse of self-expanding stent will not improve angiographic outcome at 12 months (as assessed by independent core laboratory)
Ethics approval(s)Ethics approval pending from UK Integrated Research Application System (IRAS). All other centres will seek ethics approval before recruitment of the first participant.
Health condition(s) or problem(s) studiedCerebrovascular - aneurysms
InterventionAneurysm coiling +/- stent assistance
Intervention typeProcedure/Surgery
Primary outcome measureMajor angiographic recurrence rate at 12 months post procedure
Secondary outcome measures1. Procedural outcomes (procedural morbidity & mortality)
2. Clinical outcomes: Modified Rankin Scale (MRS) at discharge, 90 days and 1 year
3. Re-bleed & retreatment rates at 1 year (and to end of trial follow-up)
4. Non target aneurysm bleeding events resulting in hospitalisation or other serious adverse event ( AE) within 30/7 of target procedure resulting in hospitalisation
Overall study start date01/06/2011
Completion date01/06/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit70 Years
SexBoth
Target number of participants550
Key inclusion criteria1. Age range 18-70 (evidence that procedural risk for stent placement in over 70 is 4 fold greater and saccular aneurysms are extremely uncommon under 18)
2. Patient world federation of neurosurgeons (WFNS) Grade 0-2 [anticipated most patients recruited will be 0]
3. Aneurysm judged suitable for treatment by coiling plus or minus the stent assistance and operator content to use/not use stent according to randomisation treatment allocation result
4. Aneurysm greater than or equal to 8mm in maximal diameter, with aneurysm neck greater than 4mm or dome to neck ratio less than 2:1, but less than 25mm in size. If target aneurysm previously treated by coiling the recurrence must have a maximal diameter in this range
5. If a patient presents with subarachnoid haemorrhage (SAH) and staged treatment with delayed stenting is judged appropriate due to aneurysm size/neck width then the patient is eligible
Key exclusion criteria1. Does not meet aneurysm size/neck characteristics outlined in inclusion criteria
2. Less than18 years or more than 70 years of age
3. Pregnant
4. Unable to consent for themselves
5. Non-saccular aneurysm - e.g. blister, fusiform or definitely dissecting aneurysm
6. Subarachnoid hemorrhage (SAH)/intracerebral haemorrhage from another aneurysm or intracranial lesion within last 28 days
7. Major surgery within last 30 days (or any other medical situation where dual antiplatelet therapy is contraindicated in the opinion of the responsible neurovascular team)
8. Intention to deploy flow diverting device/construct as primary aneurysm treatment
9. More than one aneurysm requiring treatment in current procedure
10. Target or a nearby aneurysm has had previous stent treatment such that a Vascular Reconstruction Device [VRD i.e. a stent] is already across all or greater than 1/3 of the neck of the target aneurysm
11. Medical or surgical co-morbidity such that the patient’s life expectancy is less than 1 year
12. The patient has been previously randomised into this trial
13. Patient has been randomised into another trial of an endovascular device for aneurysm treatment within the last 6 months
14. Deployment of stent judged essential to treat the aneurysm
Date of first enrolment01/06/2011
Date of final enrolment01/06/2016

Locations

Countries of recruitment

  • Germany
  • Korea, South
  • Netherlands
  • Scotland
  • Sweden
  • United Kingdom
  • United States of America

Study participating centre

Western General Hospital
Edinburgh
EH4 2XU
United Kingdom

Sponsor information

Lothian University Hospitals Division (UK)
Government

NHS Lothian
Research and Development Office
Queen Medical Research Institute
47 Little France Crescent
Edinburgh
EH16 4TJ
United Kingdom

ROR logo "ROR" https://ror.org/03q82t418

Funders

Funder type

Industry

Microvention Terumo Inc. (United States of America)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

05/04/2016: Plain English summary added.