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Ischemic StrokeImpACT-24BNCT00826059

Implant for Augmentation of Cerebral Blood Flow Trial, Effectiveness and Safety in a 24 Hour Window

A study testing Active Sphenopalatine Ganglion (SPG) Stimulation in people with Ischemic Stroke, run by BrainsGate at 73 sites in 18 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary objective of the study is to assess the safety and effectiveness of SPG stimulation with the ISS in patients with an acute ischemic stroke in the anterior circulation initiated within 24 hours from stroke onset. Read more about this study

Who is it for?
Ages 40 to 85 years
Conditions the study is for
Ischemic Stroke
What is being tested?
Active Sphenopalatine Ganglion (SPG) Stimulation
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,078 participants
Where
73 sitesin 18 countries
Study dates
Jun 2011to Jun 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age: Between 40 years and 80 years for male and 85 for female subjects
  • Clinical diagnosis of an acute ischemic stroke in the Carotid, Middle or Anterior Cerebral Artery territories
  • Imaging findings demonstrating signs of ischemia in the anterior circulation, consistent with the clinical diagnosis
  • Baseline NIHSS ≥ 7 and ≤ 18 within 2 hours prior to implantation.
  • Ability to initiate treatment within 8- 24 hours from stroke onset
  • Signed informed consent from patient him/herself or legally authorized representative if applicable

Who cannot join

  • Intracranial hemorrhage or hemorrhagic transformation
  • Massive stroke
  • Acute ischemic stroke in the posterior circulation
  • Minor stroke
  • Treated with IV-tPA (intravenous tissue Plasminogen Activator) ,IA-tPA (intra-arterial tissue Plasminogen Activator) or neurothrombectomy devices for the current stroke
  • Previous stroke in the last 6 months or pre-existing disability
Show all 16Show fewer
  • Patients with bleeding propensity or any condition in the oral cavity that prevents implantation
  • Clinical signs and symptoms or imaging evidence of bilateral stroke.
  • Treated with IV-tPA ,IA-tPA or neurothrombectomy devices for the current stroke.
  • Known cerebral arteriovenous malformation, cerebral aneurysm.
  • Clinical suspicion of septic embolus.
  • Uncontrolled hypertension (systolic >185 mmHg and/or diastolic >110 mmHg)
  • Serious systemic infection.
  • Women known to be pregnant or having a positive or indeterminate pregnancy test.
  • Patients with other implanted neural stimulator/ electronic devices (pacemakers).
  • Life expectancy < 1 year from causes other than stroke.

Trial locations and contacts

73 sites in 18 countries.

73 sites in 18 countries

Spain11 sites
  • Hospitalario Universitario de Albacete

    Albacete

  • Hospital de la Santa Creu I Sant Pau

    Barcelona

  • Hospital del Mar

    Barcelona

  • Hospital Universitari de Bellvitge

    Barcelona

  • Hospital Vall d'Hebron

    Barcelona

  • Hospital Arnau de Vilanova

    Lleida

  • Hospital Gregorio Maranon

    Madrid

  • Ramon Y Cajal

    Madrid

  • Hospital Universitario Son Dureta

    Palma de Mallorca

  • Complejo Hospitalarion Univiersitario de Santiago

    Santiago de Compostela

  • Valladolid - Hospital Clinico

    Valladolid

Other trials in Spain

Germany9 sites
  • Altenburg Clinic of Neurology

    Altenburg

  • Bad Neustadt Neurological Clinic

    Bad Neustadt an der Saale

  • Center for Stroke Research at Charite University of Berlin

    Berlin

  • Erlangen University Clinic

    Erlangen

  • Essen University Clinic

    Essen

  • Heidelberg University Clinic

    Heidelberg

  • Leipzig University Clinic

    Leipzig

  • Technical University Munich

    Munich

  • Schwarzwald-Baar Clinic

    Villingen-Schwenningen

Other trials in Germany

United States7 sites
  • Erlanger Stroke Center

    Chattanooga, Tennessee, 37403

  • Palmetto Health Richland

    Columbia, South Carolina, 29203

  • Guilford Neurologic Associates

    Greensboro, North Carolina, 27401

  • Intercoastal Medical Group

    Sarasota, Florida, 34239

  • University of Toledo Medical Center- Campus 1

    Toledo, Ohio, 43606

  • University of Toledo Medical Center- Campus 2

    Toledo, Ohio, 43606

  • Central DuPage Hospital

    Winfield, Illinois, 60190

Other trials in United States

Georgia7 sites
  • Unimed Adjara Batumi Referral Hospital

    Batumi

  • Kutaisi Referral Hospital

    Kutaisi

  • Rustavi Central Hospital

    Rustavi

  • Emergency Neurology Clinic Neurology Ltd.

    Tbilisi

  • First University Clinic

    Tbilisi

  • High Technology Medical Center University Clinic LTD.

    Tbilisi

  • Zugdidi Referral Hospital

    Zugdidi

Other trials in Georgia

Poland6 sites
  • Bialystok University Hospital

    Bialystok

  • Konske Hospital

    Gmina Końskie

  • University Hospital in Krakow

    Krakow

  • Sandomierz Hospital

    Sandomierz

  • Torun Hospital

    Torun

  • Institute of Psychiatry and Neurology

    Warsaw

Other trials in Poland

France5 sites
  • Hospital de la Cavale Blanche

    Brest

  • Hospital Nord Laennec

    Nantes

  • Hospital Saint Roch

    Nice

  • Hopital Lariboisiere

    Paris

  • Hospital Pontchaillou

    Rennes

Other trials in France

Israel5 sites
  • Barzilai Medical Center

    Ashkelon

  • Hadassah Medical Center

    Jerusalem

  • Rabin Medical Center

    Petah Tikva

  • Sourasky Medical Center

    Tel Aviv

  • The Chaim Sheba Medical Center

    Tel HaShomer

Other trials in Israel

Portugal4 sites
  • Hospital Fernando Fonseca

    Amadora

  • Hospital de Santo Antonio

    Porto

  • Unidade de AVC Centro Hospitalar São João

    Porto

  • Centro Hospitalar de Douro e Vouga, EPE - Hospital de São Sebastião

    Santa Maria

Other trials in Portugal

Czechia3 sites
  • University Hospital of Ostrava, Ostrava Poruba

    Poruba

  • General University Hospital

    Prague

  • Vitkovicka nemocnice a.s. Ostrava Vitkovice

    Vítkovice

Other trials in Czechia

Serbia3 sites
  • Special Hospital for Cerebrovascular Disease Sveti Sava

    Belgrade

  • Clinical Centre of Vojvodina

    Novi Sad

  • Clinical Hospital Center Zemun

    Zemun

Other trials in Serbia

Canada2 sites
  • Foothills Medical Centre/University of Calgary, Department of Clinical Neurosciences

    Calgary

  • Department of Medicine, Stroke Program, University of Alberta Hospital

    Edmonton

Other trials in Canada

Finland2 sites
  • Helsinki University Hospital

    Helsinki

  • Kuopio University Hospital

    Kuopio

Other trials in Finland

Hong Kong2 sites
  • Prince of Wales Hospital

    Hong Kong

  • Queen Mary Hospital

    Hong Kong

Other trials in Hong Kong

Italy2 sites
  • Hospital Sant'Andrea delle Fratte

    Perugia

  • Policlinico Umberto I

    Roma

Other trials in Italy

Slovakia2 sites
  • Neurologické Oddelenie, Nemocnica s Poliklinikou Spišská

    Nová Ves

  • Neurologické Oddelenie FN Trnava, Fakultná Nemocnica

    Trnava

Other trials in Slovakia

Denmark1 site
  • Aarhus University Hospital

    Aarhus

Other trials in Denmark

North Macedonia1 site
  • University Clinic for Neurology

    Skopje

Other trials in North Macedonia

Ukraine1 site
  • Lviv National Medical University

    Lviv

Other trials in Ukraine

About this study

Official title: A Multicenter, Randomized, Double Blind, Sham Control, Parallel Arm Trial to Assess Effectiveness and Safety of the Ischemic Stroke System ISS, as an Adjunct to Standard of Care in Subjects With Acute Ischemic Stroke

The primary objective of the study is to assess the safety and effectiveness of SPG stimulation with the ISS in patients with an acute ischemic stroke in the anterior circulation initiated within 24 hours from stroke onset.

Read the detailed description

A multi-center, multinational, randomized, blinded, sham control, adjunctive to Standard of Care, parallel arm study and will include ongoing Data Safety and Monitoring Board (DSMB) review of accumulated safety data.

Screening:

Since the treatment should be initiated within 24 hours from stroke onset, the screening window is limited and all procedures should be performed within this window.Subjects with Acute Ischemic Stroke will be screened upon arrival to the hospital. Since the treatment should be initiated between 8 and 24 hours from stroke onset, the screening window is limited and all procedures should be performed as soon as possible. All screened patients will be identified by patient number and will sign the informed consent prior to any study procedure initiation.

Period 1: Day 1-5

Day 1- Eligible subjects will be randomized to:

  • Group 1: Implantation and ISS Stimulation during five consecutive days \& Standard of Care
  • Group 2: Sham Implantation and Sham Stimulation during five consecutive days \& Standard of Care Subjects will be transferred to the implantation procedure facility and the implantation/sham implantation will be performed by a trained physician.

After implantation, active/sham stimulation will be administered in daily 4-hour sessions, beginning immediately following the placement procedure and continuing for 5 consecutive days.

Day 5 / Day of Discharge. Following the last ISS /Sham Stimulation, explantation will be performed and the patients will be evaluated for safety and effectiveness.

Subjects will continue with Standard of Care as needed and will be released from the hospital upon investigator's judgment.

Period 2: Day of Discharge - 89±7 days During this period both groups (ISS Stimulation and Sham Control) will be treated according to Standard of Care either at the hospital, rehabilitation center or at home.

Scheduled visits will be performed on day 30±7 and day 60 ±7, which will include safety and effectiveness assessments.

Final Visit Day 90±7 days: The final visit will be performed at the study site and will include safety and effectiveness evaluations.

Patients will be contacted by study personnel via telephone on Day 180±7 and on Day 360±7 in order to assess their quality of life status.

Conditions
Ischemic Stroke
Being tested
Active Sphenopalatine Ganglion (SPG) Stimulation, Sham Sphenopalatine Ganglion (SPG) Stimulation
Keywords
acute ischemic stroke, randomized clinical trial, effectiveness, safety
Medical subject headings
Ischemic Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Active Sphenopalatine Ganglion (SPG) StimulationDevice

    Also called Standard of Care

    SPG stimulation and standard of care. During all study periods, patients will receive Standard of Care in accordance to the general management of ischemic stroke and secondary prevention, following the guidelines of the American Heart Association/American Stroke Association and of the European Stroke Organization (ESO), including the use of antiplatelets, management of secondary stroke, dyslipidemia, hypertension, diabetes and counseling regarding smoking cessation. Off-label uses of drugs and devices should not occur during any of the study periods.

  • Sham Sphenopalatine Ganglion (SPG) StimulationDevice

    Also called Standard of Care

    Sham SPG stimulation and standard of care. During all study periods, patients will receive Standard of Care in accordance to the general management of ischemic stroke and secondary prevention, following the guidelines of the American Heart Association/American Stroke Association and of the European Stroke Organization (ESO), including the use of antiplatelets, management of secondary stroke, dyslipidemia, hypertension, diabetes and counseling regarding smoking cessation. Off-label uses of drugs and devices should not occur during any of the study periods.

Study groups in NCT00826059
Study groupRoleWhat they receive
Active StimulationActive comparatorImplantation/ISS Stimulation during 5 consecutive days \& Standard of Care (SoC). Day 1: First stimulation initiated within 24 hours from stroke onset, following implantation completion. All subjects will be treated according to SoC for treatment of Acute Ischemic Stroke. Day 2-4: ISS Stimulation treatment sessions repeated daily. Each treatment will be initiated within 18-26 hours from the preceding treatment. Day 5: Following completion of the last ISS Stimulation treatment session, imaging performed for assessing Injectable Neuro Stimulator (INS) positioning and/or lesion. Implant removal procedure will then be performed. Subsequently, patients will be evaluated for safety and effectiveness. Subjects will continue with SoC as needed and discharged from the hospital based on the judgment of the study investigator.
Receives: Device: Active Sphenopalatine Ganglion (SPG) Stimulation
Sham StimulationSham comparatorSham Implantation and Sham Stimulation during 5 consecutive days \& Standard of Care (SoC). Day 1: First Sham stimulation initiated within 24 hours from stroke onset, following Sham implantation procedure. All subjects will be treated according to SoC for treatment of Acute Ischemic Stroke. Day 2-4: Sham Stimulation sessions repeated daily. Each Sham Stimulation will be initiated within 18-26 hours from the preceding treatment. Day 5: Following completion of the last Sham Stimulation session, imaging performed for lesion assessment. Sham Implant removal will then be performed. Subsequently, patients will be evaluated for safety and effectiveness. Subjects will continue with SoC as needed and discharged from the hospital based on the judgment of the study investigator.
Receives: Device: Sham Sphenopalatine Ganglion (SPG) Stimulation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sliding Dichotomy modified Rankin Scale (mRS) at 3 months

    The primary efficacy endpoint is improvement beyond expectations on the modified Rankin Scale at 3 months (sliding dichotomy), assessed in primary populations of:

    1. modified intention to treat (mITT)
    2. confirmed cortical involvement (CCI), defined as baseline NIHSS ≥ 10 and signs of cortical involvement in baseline imaging (at least one of the following ASPECT regions: M1-M6, Insular Cortex) Type I Error is controlled at an overall level of 0.05 (two-sided) using the Hochberg method.

    Measured: 90 days±7 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jan 2009 (estimated)
  2. Study startJun 2011
  3. Primary completionJun 2018
  4. Study completionJun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
1,078 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00826059
Sponsor's protocol ID
CLP1000500
Acronym
ImpACT-24B
Status last verified
Mar 2019
First submitted
19 Jan 2009
Last updated
24 Feb 2020
Results posted
No
Data monitoring committee
Yes

Publications

  • Bornstein NM, Saver JL, Diener HC, Gorelick PB, Shuaib A, Solberg Y, Thackeray L, Savic M, Janelidze T, Zarqua N, Yarnitsky D, Molina CA; ImpACT-24B investigators. An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial. Lancet. 2019 Jul 20;394(10194):219-229. doi: 10.1016/S0140-6736(19)31192-4. Epub 2019 May 24.

    PubMed 31133406

Questions about this trial

What is this clinical trial studying?

A study testing Active Sphenopalatine Ganglion (SPG) Stimulation in people with Ischemic Stroke, run by BrainsGate at 73 sites in 18 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 73 sites in Spain, Germany, United States, Georgia, Poland and 13 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sliding Dichotomy modified Rankin Scale (mRS) at 3 months (time frame: 90 days±7 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00826059, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Feb 2020.

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