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MAPS Trial: Matrix And Platinum Science (MAPS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00396981
Recruitment Status : Completed
First Posted : November 8, 2006
Results First Posted : March 18, 2014
Last Update Posted : February 17, 2016
Information provided by (Responsible Party):
Stryker Neurovascular

Brief Summary:

Primary Objectives:

  • To establish Target Aneurysm Recurrence (TAR) rates for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms. TAR is defined as clinically relevant recurrence resulting in: target aneurysm reintervention, rupture/re-rupture and/or death from an unknown cause.
  • To correlate defined angiographic endpoints with TAR rates and assess their predictive value, thereby providing a framework to establish clinically relevant endpoints for future studies.

Secondary Objectives:

  • To evaluate device characteristics, incidence and severity of device-related adverse events, including death, neurological deterioration and changes in functional abilities.
  • To establish angiographic recurrence rates for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms.
  • To explore an experimental, quantitative and volumetric endpoint and correlate these with existing qualitative assessments.

Condition or disease Intervention/treatment Phase
Intracranial Aneurysms Device: Matrix 2® coils for endovascular aneurysm occlusion Device: GDC® coils for endovascular aneurysm occlusion Phase 4

Detailed Description:

The endovascular treatment of intracranial aneurysms has become an accepted alternative to surgical repair given the many recent advances with neurointerventional devices and procedures. The introduction of GDC coils in 1993 provided physicians and their patients a less invasive treatment option. Additionally, the results of two large international trials, ISAT and ISUIA, have shown the benefits of endovascular treatment over surgery for treatment of specific types of aneurysms. One limitation of endovascular coil embolization is aneurysm recurrence or recanalization which is not infrequently observed angiographically at follow up. Aneurysm recanalization may be a result of aneurysm morphology, anatomic location and flow orientation, aneurysm regrowth or the degree of coil compaction. Despite the widespread adoption of endovascular aneurysm coiling, there remains much to be learned about the efficacy and optimization of this treatment modality.

The goal of endovascular embolization of intracranial aneurysms is to prevent rupture or re-rupture. Fortunately, the incidence of aneurysm rupture following coil embolization is very low. Follow-up angiographic analysis to evaluate the occlusion and stability of the treated aneurysm provides a surrogate endpoint against which to weigh the likelihood of rupture/re-rupture. However, angiographic interpretation is subjective, operator dependent and can be influenced by multiple confounding variables.

The MAPS trial will examine Target Aneurysm Recurrence Rates: clinically relevant recurrence rates resulting in target aneurysm reintervention, rupture/re-rupture and/or death from an unknown cause for Matrix 2® and GDC® Coils used for the treatment of intracranial saccular aneurysms. The trial will compare TAR rates to recurrences measured by angiographic analysis and assess the utility of angiographic analysis for predicting clinically relevant recurrences.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 626 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Prospective, Randomized, Multicenter Trial Investigating Matrix 2® and GDC® Detachable Coils for the Treatment of Intracranial Saccular Aneurysms
Study Start Date : March 2007
Actual Primary Completion Date : January 2011
Actual Study Completion Date : March 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Aneurysms

Arm Intervention/treatment
Active Comparator: Matrix 2® Coils
Matrix 2® Coils for endovascular aneurysm occlusion
Device: Matrix 2® coils for endovascular aneurysm occlusion
endovascular aneurysm occlusion coil

Active Comparator: GDC® Coils
GDC® Coils for endovascular aneurysm occlusion
Device: GDC® coils for endovascular aneurysm occlusion
endovascular aneurysm occlusion coil

Primary Outcome Measures :
  1. Target Aneurysm Recurrence (TAR) Defined as Clinically Relevant Recurrence Resulting in Target Aneurysm Reintervention, Rupture/Re-rupture and/or Death From an Unknown Cause. [ Time Frame: 12 months ]

Secondary Outcome Measures :
  1. Angiographic Assessments [ Time Frame: Reintervention or 12 months ]
    Number of participants with angiographic assessment of "complete obliteration".

  2. Neurological Assessments [ Time Frame: 12 months ]
    The changes in modified Rankin Scores from pre-procedure to 12-month were measured. the outcome below reflects "same or better".

  3. Technical Procedure Success [ Time Frame: Post-procedure ]
  4. Target Aneurysm Recurrence [ Time Frame: 2 years ]
  5. Target Aneurysm Recurrence [ Time Frame: 3 years ]
  6. Target Aneurysm Recurrence [ Time Frame: 5 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Patient is between 18 and 80 years of age (inclusive).
  2. Patient has a documented untreated intracranial saccular aneurysm 4-20 mm diameter angiographic lumen, ruptured or unruptured, suitable for embolization with coils.
  3. Both GDC® Coils and Matrix 2® Coils (Every attempt should be made to treat with as much randomized coil type as possible to achieve optimal occlusion.) are treatment options (all shapes allowed with exception of GDC VortX Coil).
  4. Target aneurysm can be adequately coiled at index procedure (NO staged coiling procedures). If a Neuroform stent is to be placed during a separate preliminary procedure, then screening and enrollment for the coiling procedure must take place after the stenting procedure is completed.
  5. Target aneurysm morphology allows for adequate retention of coils within the aneurysmal sac without occlusion of the parent artery, as determined by the treating physician.
  6. Patient (or patient's legally authorized representative for centers in the United States) has provided written informed consent.
  7. Patient is willing and able to comply with protocol follow-up requirements.

Exclusion Criteria:

  1. Patient is < 18 or > 80 years old.
  2. Target aneurysm is not saccular in nature (mycotic, fusiform, dissecting).
  3. Target aneurysm is > 20 mm maximum luminal dimension, < 4 mm maximum luminal dimension.
  4. Target aneurysm has been previously treated by surgery or endovascular therapy.
  5. Target aneurysm is in the physician's estimation unlikely to be successfully treated by endovascular techniques.
  6. Patient presents as Hunt and Hess grade IV or V for a ruptured aneurysm.
  7. Patient presents with Modified Rankin Score 4 or 5 at baseline.
  8. Patient is concurrently enrolled in another investigational drug or device study unless permission is granted by the sponsor.
  9. Patient has known hypersensitivity to Polyglycolic Polylactic Acid (PGLA), platinum, nickel, stainless steel or structurally related compounds found in Matrix 2® Coils and/or GDC® Coils.
  10. Patients who have had or could have a severe reaction to contrast agents that cannot be adequately pre-medicated prior to the coiling procedure.
  11. Patients who are unable to complete scheduled follow up assessments at the enrolling center due to limited life expectancy (< 12 months), comorbidities or geographical considerations.
  12. Planned use of adjunctive therapy stents except Neuroform is not allowed.
  13. Patients with Moya-Moya disease, AVMs, AV fistula, intracranial tumors, intracranial hematoma (unrelated to target aneurysm), significant atherosclerotic stenosis, tortuousity or other conditions preventing access to the target aneurysm.
  14. Patients with multiple aneurysms.
  15. Target aneurysm with significant thrombosis that may increase the likelihood of recanalization at the discretion of the investigator.
  16. Female patient has a positive pregnancy assessment at baseline.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00396981

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Sponsors and Collaborators
Stryker Neurovascular
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Principal Investigator: S. Claiborne Johnston, MD, PhD University of California, San Francisco, CA
Principal Investigator: Cameron McDougall, MD Barrow Neurological Institute, Phoenix, AZ
Principal Investigator: Anil Gholkar, MD Newcastle Upon Tyne Hospitals, NHS Trust, UK
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Stryker Neurovascular Identifier: NCT00396981    
Other Study ID Numbers: T4902
BSC0015 ( Other Identifier: Stryker Neurovascular )
First Posted: November 8, 2006    Key Record Dates
Results First Posted: March 18, 2014
Last Update Posted: February 17, 2016
Last Verified: January 2016
Keywords provided by Stryker Neurovascular:
Intracranial saccular aneurysms
Endovascular coiling therapy
Raymond scale
Guglielmi Detachable Coil
Additional relevant MeSH terms:
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Intracranial Aneurysm
Vascular Diseases
Cardiovascular Diseases
Intracranial Arterial Diseases
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases