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Ischemic Stroke, AcuteSFERANCT05225636

Stroke Process in FEmoral Versus Radial Access

A study testing thrombectomy in people with Ischemic Stroke, Acute, run by Hospital Universitari Vall d'Hebron Research Institute at 2 sites in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In patients with suspected acute stroke due to large vessel occlusion with indication for endovascular treatment, radial access is just as safe, fast, and effective as femoral access, and it improves the entire stroke treatment process. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Ischemic Stroke, Acute
What is being tested?
thrombectomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
2 sitesSpain
Study dates
15 Sep 2021to 28 Apr 2023
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with high suspicion of ischemic stroke due to large cerebral vessel occlusion defined by NIHSS> 10.
  • Immediate availability of the entire team responsible for endovascular treatment (Neurologist, Neurointerventional physician, Anesthetist, Nursing, Technicians ...)
  • Radial artery diameter ≥2.5 mm
  • Presence of femoral pulse or patency by ultrasonography in its defect.
  • Previous functional independence (mRS 0-2).

Who cannot join

  • Life expectancy of less than 6 months.
  • Intracranial hemorrhage
  • Patients with pre-existing neurological or psychiatric pathology that may confuse future evaluations.
  • No availability for follow-up after 90 days.

Trial locations and contacts

2 sites in 1 country.

Spain2 sites, 2 recruiting
  • Hospital Universitari Vall d'Hebron. Universitat Autonoma de Barcelona

    Barcelona, 08035

    Alejandro Tomasello, MD, 934893000 ext. 6441, alejandrotomasello@gmail.com

    Recruiting
  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

    Alejandro Tomasello, MD, 93489300 ext. 6441, alejandrotomasello@gmail.com

    David Hernandez, MD, 93489300 ext. 6748, dhm050780@gmail.com

    Recruiting

Other trials in Spain

About this study

In patients with suspected acute stroke due to large vessel occlusion with indication for endovascular treatment, radial access is just as safe, fast, and effective as femoral access, and it improves the entire stroke treatment process.

Read the detailed description

Investigators will compare the procedure times, angiographic results as well as the clinical evolution and the patient's experience during their hospital stay and after discharge, depending on the arterial access practiced for mechanical thrombectomy.

Being tested
thrombectomy
Keywords
Radial access, Femoral access, Thrombectomy
Medical subject headings
Ischemic Stroke

What participants receive

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

  • thrombectomyProcedure or surgery

    Extraction of intracranial thrombus in an acute large vessel occlusion

Study groups in NCT05225636
Study groupRoleWhat they receive
Radial accessActive comparatorThe ischemic stroke treatment will be performed through the radial artery (as first option)
Receives: Procedure: thrombectomy
Femoral accessActive comparatorThe ischemic stroke treatment will be performed through the femoral artery (as first option)
Receives: Procedure: thrombectomy

What is being measured

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

  1. No inferiority of radial access in the recanalization rate

    To demonstrate the non-inferiority of radial access with respect to femoral access in the recanalization rate (% mTICI 2b-3 in 3 or fewer passes) obtained in patients with large vessel occlusion treated by mechanical thrombectomy.

    Measured: Immediate after treatment

Secondary outcomes (7)
  1. No differences in complications in vascular access

    Comparison in frequency of access vessel occlusion, bleeding or presence of pseudoaneurysm

    Measured: 24 hours

  2. Grades of modified Thrombolysis in Cerebral Infarction

    Grade of recanalization after first pass, third pass and at the end of the procedure

    Measured: 24 hours

  3. Change of artery access

    Rate of need to change from radial to femoral access and from femoral to radial access

    Measured: 24 hours

  4. Patient Reported Outcomes

    PROMS Patient Reported Outcomes Measures

    Measured: 5 days

  5. Patient experience

    PREMS Patient Reported Experience Measures

    Measured: 5 days

  6. Degree of disability/dependence after a stroke

    modified rankin scale (from 0 to 6, being 0 best and 6 worst)

    Measured: 24 hours and at 90 days

  7. Times during hospitalization

    Beginning of sitting, ambulation, rehabilitation and total time of hospital admission, need for urinary catheter

    Measured: At 24 hours and during first 5 days

Timeline

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

  1. First posted4 Feb 2022
  2. Study start15 Sep 2021
  3. Primary completion15 Jan 2023 (estimated)
  4. Study completion28 Apr 2023 (estimated)

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
Model description
Randomized, prospective clinical trial, under conditions of routine, open-label clinical practice, with the main objective evaluated by an independent investigator who was not blinded to the treatment received. The study will be single-center.
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05225636
Sponsor's protocol ID
PR(AG)209/2021
Acronym
SFERA
Status last verified
Jan 2022
First submitted
27 Aug 2021
Last updated
4 Feb 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: After finishing the study we will share all the data if a collaboration is proposed

Publications

  • Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, Davalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira VM, Rempel J, Millan M, Davis SM, Roy D, Thornton J, Roman LS, Ribo M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG; HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016 Apr 23;387(10029):1723-31. doi: 10.1016/S0140-6736(16)00163-X. Epub 2016 Feb 18.

    PubMed 26898852
  • Saver JL, Goyal M, van der Lugt A, Menon BK, Majoie CB, Dippel DW, Campbell BC, Nogueira RG, Demchuk AM, Tomasello A, Cardona P, Devlin TG, Frei DF, du Mesnil de Rochemont R, Berkhemer OA, Jovin TG, Siddiqui AH, van Zwam WH, Davis SM, Castano C, Sapkota BL, Fransen PS, Molina C, van Oostenbrugge RJ, Chamorro A, Lingsma H, Silver FL, Donnan GA, Shuaib A, Brown S, Stouch B, Mitchell PJ, Davalos A, Roos YB, Hill MD; HERMES Collaborators. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016 Sep 27;316(12):1279-88. doi: 10.1001/jama.2016.13647.

    PubMed 27673305
  • Mazighi M, Chaudhry SA, Ribo M, Khatri P, Skoloudik D, Mokin M, Labreuche J, Meseguer E, Yeatts SD, Siddiqui AH, Broderick J, Molina CA, Qureshi AI, Amarenco P. Impact of onset-to-reperfusion time on stroke mortality: a collaborative pooled analysis. Circulation. 2013 May 14;127(19):1980-5. doi: 10.1161/CIRCULATIONAHA.112.000311.

    PubMed 23671178
  • Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J. 2009 Jan;157(1):132-40. doi: 10.1016/j.ahj.2008.08.023. Epub 2008 Nov 1.

    PubMed 19081409
  • Valgimigli M, Gagnor A, Calabro P, Frigoli E, Leonardi S, Zaro T, Rubartelli P, Briguori C, Ando G, Repetto A, Limbruno U, Cortese B, Sganzerla P, Lupi A, Galli M, Colangelo S, Ierna S, Ausiello A, Presbitero P, Sardella G, Varbella F, Esposito G, Santarelli A, Tresoldi S, Nazzaro M, Zingarelli A, de Cesare N, Rigattieri S, Tosi P, Palmieri C, Brugaletta S, Rao SV, Heg D, Rothenbuhler M, Vranckx P, Juni P; MATRIX Investigators. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet. 2015 Jun 20;385(9986):2465-76. doi: 10.1016/S0140-6736(15)60292-6. Epub 2015 Mar 16.

    PubMed 25791214
  • Chase AJ, Fretz EB, Warburton WP, Klinke WP, Carere RG, Pi D, Berry B, Hilton JD. Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart. 2008 Aug;94(8):1019-25. doi: 10.1136/hrt.2007.136390. Epub 2008 Mar 10.

    PubMed 18332059
  • Bertrand OF, Belisle P, Joyal D, Costerousse O, Rao SV, Jolly SS, Meerkin D, Joseph L. Comparison of transradial and femoral approaches for percutaneous coronary interventions: a systematic review and hierarchical Bayesian meta-analysis. Am Heart J. 2012 Apr;163(4):632-48. doi: 10.1016/j.ahj.2012.01.015.

    PubMed 22520530
  • Kolkailah AA, Alreshq RS, Muhammed AM, Zahran ME, Anas El-Wegoud M, Nabhan AF. Transradial versus transfemoral approach for diagnostic coronary angiography and percutaneous coronary intervention in people with coronary artery disease. Cochrane Database Syst Rev. 2018 Apr 18;4(4):CD012318. doi: 10.1002/14651858.CD012318.pub2.

    PubMed 29665617
  • Ghani MR, Busa V, Dardeir A, Marudhai S, Patel M, Abdelmoneim YM, Jan A, Eskander N. Mechanical Thrombectomy in Patients With Acute Ischemic Stroke: A Comparison of Transradial Versus Transfemoral Cerebral Angiography. Cureus. 2020 Oct 12;12(10):e10919. doi: 10.7759/cureus.10919.

    PubMed 33194486
  • Phillips TJ, Crockett MT, Selkirk GD, Kabra R, Chiu AHY, Singh T, Phatouros C, McAuliffe W. Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: analysis of 375 consecutive cases. Stroke Vasc Neurol. 2021 Jun;6(2):207-213. doi: 10.1136/svn-2020-000624. Epub 2020 Nov 16.

    PubMed 33199413
  • Chen SH, Snelling BM, Sur S, Shah SS, McCarthy DJ, Luther E, Yavagal DR, Peterson EC, Starke RM. Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: comparison of technical and clinical outcomes. J Neurointerv Surg. 2019 Sep;11(9):874-878. doi: 10.1136/neurintsurg-2018-014485. Epub 2019 Jan 22.

    PubMed 30670623
  • Khanna O, Mouchtouris N, Sweid A, Chalouhi N, Ghosh R, Al Saiegh F, Gooch MR, Tjoumakaris S, Rosenwasser RH, Romo V, Jabbour P. Transradial approach for acute stroke intervention: technical procedure and clinical outcomes. Stroke Vasc Neurol. 2019 Nov 27;5(1):103-106. doi: 10.1136/svn-2019-000263. eCollection 2020.

    PubMed 32411415
  • Crockett MT, Selkirk GD, Chiu AHY, Singh TP, McAuliffe W, Phillips TJ. First line transradial access for posterior circulation stroke intervention; initial 12-month experience at a high volume thrombectomy center. J Clin Neurosci. 2020 Aug;78:194-197. doi: 10.1016/j.jocn.2020.04.069. Epub 2020 Apr 23.

    PubMed 32336634
  • Maud A, Khatri R, Chaudhry MRA, Vellipuram A, Cruz-Flores S, Rodriguez GJ. Transradial Access Results in Faster Skin Puncture to Reperfusion Time than Transfemoral Access in Posterior Circulation Mechanical Thrombectomy. J Vasc Interv Neurol. 2019 May;10(3):53-57.

    PubMed 31308872
  • Khanna O, Sweid A, Mouchtouris N, Shivashankar K, Xu V, Velagapudi L, Stricsek G, Amllay A, Texakalidis P, Gooch MR, Tjoumakaris S, Rosenwasser RH, Jabbour PM. Radial Artery Catheterization for Neuroendovascular Procedures. Stroke. 2019 Sep;50(9):2587-2590. doi: 10.1161/STROKEAHA.119.025811. Epub 2019 Jul 17.

    PubMed 31311466

Questions about this trial

What is this clinical trial studying?

A study testing thrombectomy in people with Ischemic Stroke, Acute, run by Hospital Universitari Vall d'Hebron Research Institute at 2 sites in Spain.

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 5 inclusion and 4 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: status not confirmed, as of the sponsor's last update on 4 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Spain. 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. 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?

Results are not available in the source record.

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

Contact DAVID HERNANDEZ, MD (+34934893000 ext. 6441, dhm050780@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

No inferiority of radial access in the recanalization rate (time frame: Immediate after treatment). 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 NCT05225636, which also lists 17 linked publications.

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 4 Feb 2022.

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