Evaluating Oral Peri-operative Acetylsalicylic Acid in Subjects Undergoing Endovascular Coiling-only of Unruptured Brain Aneurysms
Unruptured Cerebral AneurysmThis trial is a is a prospective, randomized (1:1) placebo-controlled, clinical trial with blinded endpoint assessment of 440 participants with unruptured brain aneurysm planned for endovascular treatment using coiling-only approach (primary coiling or using balloon-assistance but not stenting) to test if oral acetylsalicylic acid (325 mg/ day for a total of 5 days) is superior placebo in preventing clinical and silent strokes. The primary outcome is a clinical or silent stroke at the time of discharge assessed by clinical examination and MRI brain. Participants will return to the clinic or be contacted by phone for the end of study procedures on Day 90 to collect functional outcome data.
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Participation Requirements
-
Sex:
ALL -
Eligible Ages:
18 and up
Participation Criteria
Inclusion Criteria:
* Unruptured intracranial aneurysm suitable for coiling-only (primary coiling or balloon-assisted) as a primary treatment.
* Functionally independent at baseline (modified Rankin scale \<3).
* Informed consent and availability of the subject for the entire study period.
Exclusion Criteria:
1. Planned complex aneurysm treatment including use of any device that requires post-operative antiplatelet therapy (stent-assisted coiling or flow-diverter device), or endovascular vessel sacrifice.
2. Dissecting or mycotic brain aneurysm.
3. Any ongoing ischemic symptoms such as transient ischemic attacks, minor strokes, or stroke-in-evolution within 2 weeks before randomization.
4. Allergy or contraindication to ASA.
5. Unable to take study drug orally for any reason.
6. Subjects already taking single or dual antiplatelet, warfarin, or any of the non-Vitamin K antagonist oral anticoagulants.
7. Subjects unable to undergo MRI imaging for any reason (e.g., severe claustrophobia or presence of metals).
8. Any other medical condition that the site investigator deems would put the subject at excessive risk by participation in the study (e.g. active bleeding, symptomatic peptic ulcer disease, liver or kidney failure, thrombocytopenia or coagulopathy) or an expected life expectancy less than one year, or that would result in an inability to collect radiological outcomes and clinical outcomes at 90 days.
9. Pregnancy or breastfeeding.
10. Prior enrollment in EVOLVE trial for another aneurysm.
11. Participation in another clinical trial of an investigational drug, device or procedure if the subject received the trial drug, device or procedure in the preceding 30 days from the anticipated coiling date.
Study Location
Dalhousie University
Dalhousie UniversityHalifax, Nova Scotia
Canada
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Adrienne Weeks, MD, PhD, FRCSC
McGill University
McGill UniversityMontréal, Quebec
Canada
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Maria Cortes, MD
U of Alberta
U of AlbertaEdmonton, Alberta
Canada
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Cian O'Kelly, MD FRCSC
Toronto Western Hospital
Toronto Western HospitalToronto, Ontario
Canada
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Ronit Agid, MD, FRCPC
McMaster University
McMaster UniversityHamilton, Ontario
Canada
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BRIAN VAN ADEL, MD, PhD, FRCPC
University of Saskatchewan
University of SaskatchewanSaskatoon, Saskatchewan
Canada
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Michael Kelly, MD, PhD, FRCSC, FACS, FAANS
Foothills Medical Center
Foothills Medical CenterCalgary, Alberta
Canada
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Dr Alim Mitha, MD FRCSC
Toronto St Michael's Hospital
Toronto St Michael's HospitalToronto, Ontario
Canada
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Aditya Bharatha, MD FRCPC
- Study Sponsored By
- University of Calgary
- Participants Required
- More Information
- Study ID:
NCT04192955