Barrow Ruptured Aneurysm Trial (BRAT)
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Purpose
With evolving endovascular technologies there is a growing debate centered on the relative safety and efficacy of the currently accepted alternatives for the treatment of ruptured cerebral aneurysms in the face of acute subarachnoid hemorrhage (SAH). The purpose of this study is to compare the safety and efficacy of microsurgical clipping and endovascular coiling of acutely ruptured cerebral aneurysms in a prospective, randomized fashion.
| Condition | Intervention |
|---|---|
|
Ruptured Cerebral Aneurysm Subarachnoid Hemorrhage (SAH) |
Procedure: coil embolization Procedure: clip occlusion |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Barrow Ruptured Aneurysm Study |
- Modified Rankin Scale [ Time Frame: 6 years ] [ Designated as safety issue: No ]Primary Outcome Measure is Modified Rankin Scale < or = to 2. Data will be analyzed on intent to treat basis with crossover to the alternative treatment analyzed as a data subset. The null hypothesis is that no difference in outcome will be detected between the endovascular and surgical treatment arms. A statistically significant difference will then be considered evidence in favor of the alternative hypothesis, that one treatment is superior to the other.
| Enrollment: | 500 |
| Study Start Date: | November 2002 |
| Estimated Study Completion Date: | January 2013 |
| Estimated Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Endovascular
Subjects randomized to endovascular coil embolization will be treated by one of two neurosurgeons expert in such treatment. All endovascular coil embolization treatments will be accomplished using accepted techniques.
|
Procedure: coil embolization
Subjects randomized to endovascular therapy will be treated by one of two neurosurgeons expert in such treatment. All endovascular treatments will be accomplished using accepted techniques.
|
|
Active Comparator: Surgical
Subjects randomized to surgical clip occlusion repair will receive treatment from one of two neurosurgeons expert in clip occlusion surgery for ruptured aneurysms.
|
Procedure: clip occlusion
Subjects randomized to surgical therapy will receive treatment from one of two neurosurgeons expert in surgery for ruptured aneurysms.
|
Detailed Description:
The planned trial enrolled 250 subjects per arm. Subjects are followed postoperatively and outcome endpoints will be assessed at Discharge, 6 Months, 1 Year, 3 Years, and 6 Years. One hundred (100) subjects will participate in neuropsychological testing at 1 Year; after the 100th subject an interim data analysis will be performed and the viability of future neuropsychological testing will be determined. Subjects will receive preoperative, intraoperative or postoperative, 3 Year follow up, and 6 Year follow up angiograms. In this fashion immediate clinical outcome, including peri-procedural morbidity and mortality, will be assessed as will long term outcome, both clinical and angiographic.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Acute subarachnoid hemorrhage (SAH)
- Confirmed by CT scan or lumbar puncture
- Age 18-80 years
- Ability to give informed consent (subject or legally authorized representative)
- No anatomic inclusions
Exclusion Criteria:
- Traumatic subarachnoid hemorrhage
- Presents to hospital >14 days post-bleed
- SAH caused by other primary disease
- No anatomic exclusions
Contacts and Locations| United States, Arizona | |
| St. Joseph's Hospital and Medical Center | |
| Phoenix, Arizona, United States, 85013 | |
| Principal Investigator: | Robert F Spetzler, MD | Barrow Neurosurgical Associates |
| Principal Investigator: | Cameron G McDougall, MD | Barrow Neurosurgical Associates |
More Information
Publications:
| Responsible Party: | Toby L. Anchie, R.N., MAEd, Executive Director, Research & Development, St. Joseph's Hospital and Medical Center, Phoenix |
| ClinicalTrials.gov Identifier: | NCT01593267 History of Changes |
| Other Study ID Numbers: | 02BN090 |
| Study First Received: | April 30, 2012 |
| Last Updated: | September 18, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by St. Joseph's Hospital and Medical Center, Phoenix:
|
intracranial aneurysm subarachnoid hemorrhage randomized trial |
coil embolization clip occlusion vascular disorders |
Additional relevant MeSH terms:
|
Aneurysm Aneurysm, Ruptured Intracranial Aneurysm Brain Diseases Hemorrhage Subarachnoid Hemorrhage Rupture Vascular Diseases |
Cardiovascular Diseases Pathologic Processes Intracranial Hemorrhages Cerebrovascular Disorders Central Nervous System Diseases Nervous System Diseases Wounds and Injuries Intracranial Arterial Diseases |
ClinicalTrials.gov processed this record on May 23, 2013