A Study of Implantation of CRENEOUS ENTERPRISE 2 Intracranial Stent in Participants With Severe Symptomatic Intracranial Atherosclerotic Stenosis

Launched by MEDOS INTERNATIONAL SARL · Mar 30, 2022

Keywords

ClinConnect Summary

This clinical trial is investigating the use of a special device called the CERENOVUS ENTERPRISE 2 intracranial stent to help patients with severe narrowing of blood vessels in the brain due to a condition known as intracranial atherosclerosis. The goal is to see if this stent can safely improve blood flow and reduce symptoms in patients who are experiencing recurrent strokes despite being on medical treatment.

To be eligible for the study, participants need to be between 22 and 80 years old and have a significant narrowing (70-99%) in an artery in the brain. They should also have had at least two strokes in the past year while receiving treatment for their condition. Participants will receive the stent and will need to attend follow-up visits to monitor their health. It's important to note that certain health conditions, such as recent strokes or specific heart problems, would exclude someone from participating in this trial.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Pre-procedure inclusion criteria
• • Participants aged 22-80 years old
• • All participants are required to meet at least one additional criteria (a-f) provided below to qualify for the study; (a) insulin dependent diabetes for at least 15 years; (b) at least 2 of the following atherosclerotic risk factors: hypertension (blood pressure \[BP\] greater than or equal to \[\>=\] 140/90 or on antihypertensive therapy); dyslipidemia (low density lipoprotein \[LDL\] 130 milligrams per deciliter \[mg/dl\] or high density lipoprotein \[HDL\] less than \[\<\] 40 mg/dl or fasting triglycerides \>= 150 mg/dl or on lipid lowering therapy); smoking; abnormal glucose metabolism (fasting blood glucose \>= 6.2 millimole per liter (mmol/L) or 2 hours postprandial blood glucose \>= 7.8mmol/L); family history of any of the following: myocardial infarction, coronary artery bypass, coronary angioplasty or stenting, stroke, carotid endarterectomy or stenting, peripheral vascular surgery in parent or sibling who was \<55 years of age for men or \<65 for women at the time of the event ; (c) history of any of the following: myocardial infarction, coronary artery bypass, coronary angioplasty or stenting, carotid endarterectomy or stenting, or peripheral vascular surgery for atherosclerotic disease ; (d) any stenosis of an extracranial carotid or vertebral artery, another intracranial artery, subclavian artery, coronary artery, iliac or femoral artery, other lower or upper extremity artery, mesenteric artery, or renal artery that was documented by non-invasive vascular imaging or catheter angiography and is considered atherosclerotic ; (e) Aortic arch atheroma or atherosclerotic aortic aneurysm documented by non-invasive vascular imaging or catheter angiography ; (f) High resolution magnetic resonance imaging (MRI) imaging confirmed the presence of atherosclerotic plaques in the target arterial stenosis
• • Participants with symptomatic intracranial atherosclerotic stenosis who is receiving medical treatment (that is, receiving at least one antithrombotic medication and vascular risk factor management) but still had recurrent (2 or more) ischemic strokes during the medical treatment period within past year
• • Vascular diameter proximal to the stenosis must be measured at 2.0-4.0 millimeters (mm)
• • Modified Rankin Scale (mRS) \<= 2
• • Stenosis of 70%-99% on non-invasive vascular imaging or digital subtraction angiography (DSA), with normal distal vessel
• • Participant is willing and able to return for all follow-up visits required by the protocol
• • Participants understand the purpose and requirements of the study and have signed an informed consent form Intra procedure
• • Stenosis of 70 percent (%) -99% on digital subtraction angiography (DSA), with normal distal vessel
• Exclusion Criteria:
• • Participant underwent an acute ischemic stroke within 2 weeks
• • Participants in whom one stent can't cover the lesion length or the use of multiple stents is required
• • Greater than (\>) 50% stenosis proximal or distal to the target intracranial lesion
• • Intracranial arterial stenosis related to non-atherosclerotic factors, such as: arterial dissection, moya-moya disease; vasculitic disease; herpes zoster, varicella zoster or other viral vasculopathy; neurosyphilis; any other intracranial infection; any intracranial stenosis associated with cerebrospinal fluid pleocytosis; radiation-induced vasculopathy; fibromuscular dysplasia; sickle cell disease; neurofibromatosis; benign angiopathy of central nervous system; postpartum angiopathy; suspected vasospastic process, and developmental or genetic abnormalities
• • Participants with symptoms of cerebral ischemia caused by cardiac embolism
• • Severe vascular tortuosity, highly calcified or anatomy that would preclude the safe introduction of a guiding catheter, guiding sheath or stent placement
• • Myocardial infarction within previous 30 days
• • Permanent atrial fibrillation, persistent atrial fibrillation, any episode of paroxysmal atrial fibrillation within the past six months, or history of paroxysmal atrial fibrillation requiring chronic anticoagulation
• • Intolerance or allergic reaction to any of antithrombotic therapy or medicine used during the procedure
• • History of life-threatening allergy to contrast medium. If not life threatening and can be effectively pre-treated, participant can be enrolled at investigators' discretion
• • Surgery within previous 30 days or planned in the next 90 days after enrollment
• • Intracranial hemorrhage within 3 months
• • Concomitant intracranial tumor, aneurysm or arteriovenous malformation
• • Haemoglobin \<10 grams per deciliter (g/dL), blood platelet count \<80000 per milliliters (/ml), international normalization ratio \>1.5, or other uncorrectable coagulopathies.
• • Life expectancy of \<3 years due to the concomitant illness.
• • Pregnant or lactating women
• • Participants judged unsuitable for stenting and angioplasty by the investigator