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Evaluating Oral Peri-operative Acetylsalicylic Acid in Subjects Undergoing Endovascular Coiling-only of Unruptured Brain Aneurysms

Unruptured Cerebral Aneurysm

This 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 University
Halifax, Nova Scotia
Canada

Contact Study Team

Primary Contact

Adrienne Weeks, MD, PhD, FRCSC

McGill University
McGill University
Montréal, Quebec
Canada

Contact Study Team

Primary Contact

Maria Cortes, MD

U of Alberta
U of Alberta
Edmonton, Alberta
Canada

Contact Study Team

Primary Contact

Cian O'Kelly, MD FRCSC

Toronto Western Hospital
Toronto Western Hospital
Toronto, Ontario
Canada

Contact Study Team

Primary Contact

Ronit Agid, MD, FRCPC

McMaster University
McMaster University
Hamilton, Ontario
Canada

Contact Study Team

Primary Contact

BRIAN VAN ADEL, MD, PhD, FRCPC

University of Saskatchewan
University of Saskatchewan
Saskatoon, Saskatchewan
Canada

Contact Study Team

Primary Contact

Michael Kelly, MD, PhD, FRCSC, FACS, FAANS

Foothills Medical Center
Foothills Medical Center
Calgary, Alberta
Canada

Contact Study Team

Backup Contact

Dr Alim Mitha, MD FRCSC

Toronto St Michael's Hospital
Toronto St Michael's Hospital
Toronto, Ontario
Canada

Contact Study Team

Primary Contact

Aditya Bharatha, MD FRCPC

Study Sponsored By
University of Calgary
Participants Required
More Information
Study ID: NCT04192955