症状性颅内动脉粥样硬化狭窄比较颅内血管成形支架植入术联合最佳药物治疗与单纯最佳药物治疗的多中心、前瞻性登记研究

注册号:

Registration number:

ChiCTR1900027538 

最近更新日期:

Date of Last Refreshed on:

2019-11-17 20:21:52 

注册时间:

Date of Registration:

2019-11-17 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

症状性颅内动脉粥样硬化狭窄比较颅内血管成形支架植入术联合最佳药物治疗与单纯最佳药物治疗的多中心、前瞻性登记研究

Public title:

A Multicenter Prospective Registration Study for Stenting Plus Standard Medical Treatment Versus Standard Medical Treatment Alone for Symptomatic Intracranial Atherosclerotic Stenosis

注册题目简写:

EPZ

English Acronym:

EPZ

研究课题的正式科学名称:

症状性颅内动脉粥样硬化狭窄比较颅内血管成形支架植入术联合最佳药物治疗与单纯最佳药物治疗的多中心、前瞻性登记研究

Scientific title:

A Multicenter Prospective Registration Study for Stenting Plus Standard Medical Treatment Versus Standard Medical Treatment Alone for Symptomatic Intracranial Atherosclerotic Stenosis

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

桑红菲 

研究负责人:

杨清武 

Applicant:

Hongfei Sang 

Study leader:

Qingwu Yang 

申请注册联系人电话:

Applicant telephone:

+86 13738132047

研究负责人电话:

Study leader's
telephone:

+86 13657638868

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

sanghongfei1988@163.com

研究负责人电子邮件:

Study leader's E-mail:

yangqwmlys@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

重庆市沙坪坝区新桥正街183号

研究负责人通讯地址:

重庆市沙坪坝区新桥正街183号

Applicant address:

183 Xinqiao Main Street, Shapingba District, Chongqing, China

Study leader's address:

183 Xinqiao Main Street, Shapingba District, Chongqing, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

第三军医大学新桥医院

Applicant's institution:

Xinqiao Hospital, the Third Military Medical University

研究负责人所在单位:

第三军医大学新桥医院

Affiliation of the Leader:

Xinqiao Hospital, the Third Military Medical University

是否获伦理委员会批准:

Approved by ethic committee:

No

伦理委员会批件文号:

Approved No. of ethic committee:

伦理委员会批件附件:

Approved file of Ethical Committee:

批准本研究的伦理委员会名称:

Name of the ethic committee:

伦理委员会批准日期:

Date of approved by ethic committee:

2013-08-26 00:00:00

伦理委员会联系人:

Contact Name of the ethic committee:

伦理委员会联系地址:

Contact Address of the ethic committee:

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

第三军医大学新桥医院

Primary sponsor:

Xinqiao Hospital, the Third Military Medical University

研究实施负责(组长)单位地址:

重庆市沙坪坝区新桥正街183号

Primary sponsor's address:

183 Xinqiao Main Street, Shapingba District, Chongqing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

Country:

China

Province:

Chongqing

City:

单位(医院):

新桥医院

具体地址:

沙坪坝区新桥正街183号

Institution
hospital:

Xinqiao Hospital

Address:

183 Xinqiao Main Street, Shapingba District

经费或物资来源:

自筹经费

Source(s) of funding:

self-financing

研究疾病:

症状性颅内动脉粥样硬化狭窄  

Target disease:

symptomatic intracranial atherosclerosis stenosis

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

针对ICAS缺血性卒中患者,首先比较颅内血管成形支架植入术联合最佳药物治疗与最佳药物治疗两种治疗方案的有效性及安全性。其次,研究未被FDA批准用于治疗ICAS的支架的有效性及安全性是否非劣于被FDA批准的支架。  

Objectives of Study:

The first goal is to observe the efficacy and safety of stenting plus standard medical treatment versus standard medical treatment alone for symptomatic intracranial atherosclerotic stenosis, and the second goal is to compare the efficacy and safety of stent approved by FDA with stent not approved by FDA for symptomatic intracranial atherosclerotic stenosis,

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1)近1周内由临床症状或经头颅MRI证实为急性缺血性卒中;
2)经MRI明确的单纯穿支动脉闭塞引起的卒中;
3)目标血管狭窄段近端存在串联颅外血管狭窄率>50%或闭塞;
4)目标血管严重钙化;
5)目标血管近端或远端严重迂曲,预期颅内支架不能输送到位;
6)目标血管狭窄段或其近端存在血栓;
7)非动脉粥样硬化病变引起的颅内动脉狭窄,包括:动脉夹层、moya-moya病、脉管炎疾病、带状疱疹、水痘带状疱疹或其他病毒性血管病、神经梅毒、任何其他颅内感染、与脑脊液细胞增多有关的任何颅内狭窄、辐射诱导的血管病变、纤维肌性发育不良、镰状细胞病、神经纤维瘤病、中枢神经系统良性血管病、产后血管病、怀疑血管痉挛、可疑栓子再通等;
8)心源性卒中或潜在心源性血栓,存在以下任何明确的心源性栓塞原因:慢性或阵发性心房颤动,二尖瓣狭窄,机械瓣膜,心内膜炎,心内血栓或植入物,扩张型心肌病,左心房自发声学显影;
9)合并颅内肿瘤、动脉瘤或颅内动静脉畸形;
10)既往有颅内或颅外动脉支架植入、血管成形或内膜剥脱术史;
11)既往原发性脑出血病史;12)入组前24小时内接受溶栓治疗者;
13)入组前24小时内神经功能恶化(定义为:美国国立卫生研究院卒中量表(NIHSS)评分较基线增加≥4分);
14)近30天内任何脑实质或其他颅内蛛网膜下腔、硬膜下或硬膜外出血病史;
15)近30天内心肌梗死;
16)近30天内或计划在90天内进行重大手术(包括开放式股动脉,主动脉或颈动脉手术);
17)对相关药物(肝素、造影剂、阿司匹林及氯吡格雷等)或操作装置过敏或过敏体质,以及对上述药物使用存在禁忌证患者;
18)射血分数<40%,心、肺等重要脏器功能不全致不能耐受全麻者;
19)血红蛋白<100g/L,血小板<100*109/L,红细胞压积<25%;
20)严重肝功能损害,ALT>3倍正常上限或AST>3倍正常上限;严重肾功能不全(肾小球滤过率<30mL/min/1.73m2),目前进行血液透析者;
21)活动性消化性溃疡,30天内严重全身性出血,活动性出血体质,目前酒精或药物滥用,未控制的严重高血压(收缩压>180mmHg或舒张压>115mmHg);
22)遗传学或获得性出血体质,抗凝因子缺乏;或入组前已行抗凝治疗且INR>1.5;
23)华法林或肝素的使用超过研究规定范畴(注:在支架植入术中允许全身肝素化,在住院期间允许皮下注射肝素用于预防深静脉血栓形成);
24)老年痴呆症或精神疾病影响患者可靠地遵循随访计划;
25)妊娠或哺乳期妇女,或一年内计划怀孕者;
26)任何疾病晚期致预期寿命<12个月;
27)预期不能完成随访。

Exclusion criteria:

1) Acute ischemic stroke in the last 1 weeks;
2) Tandem extracranial stenosis (>50 %) or occlusion that is proximal l to the target intracranial lesion;
3) Perforator artery strokes;
4) Severe calcification at target lesion;
5) Severe vascular tortuosity or anatomy that would preclude stenting or angiography;
6) Thrombus is present at target artery or its proximal;
7) Non-atherosclerotic intracranial stenosis, including arterial dissection, moya-moya disease; vasculitic disease; herpes zoster, varicella zoster or other viral vasculopathy; neurosyphilis; any other intracranial infection; any intracranial stenosis associated with cerebrospinal fluid pleocytosis; radiation-induced vasculopathy; fibromuscular dysplasia; sickle cell disease; neurofibromatosis; benign angiopathy of central nervous system; postpartum angiopathy; suspected vasospastic process, and suspected recanalized embolus;
8) Potential cardiac embolism;
9) Concomitant intracranial tumour, aneurysm or arteriovenous malformation;
10) A history of intracranial or extracranial stent implantation angioplasty or endarterectomy;
11) Previous spontaneous intracerebral (parenchymal) or other intracranial (subarachnoid, subdural, or epidural) hemorrhage within 30 days;
12) Rt-PA treatment within 24 hours before enrollment;
13) Neurological deterioration within 24 hours before enrollment;
14) Myocardial infarction within previous 30 days;
15) Major surgery (including open femoral, aortic or carotid surgery) within the last 1 month;
16) Allergic to and known contraindications for medications (heparin, contrast agents, aspirin and clopidogrel) or operating devices;
17) Ejection fraction <40% and the important organs are unable to tolerate general anesthesia;
18) HGB<100g/L, PLT<100*10^9/L or hematocrit<25%; glucose<50mg/dl(2.8mmol/L) or >400mg/dl (22.2mmol/L);
19) Severe liver impairment (AST or. ALT >3 times normal, cirrhosis)severe renal insufficiency (eGFR <30 mL / min / 1.73 m2);
20)A history of systemic hemorrhage in the last 1 months;
21) Active bleeding diathesis or coagulopathy anticoagulant factor deficiency INR>1.5:
22) Warfarin or heparin beyond the guidelines;
23) Alzheimer's disease or mental illness;
24) Pregnant or lactating women, or those planning to become pregnant within one year;
25) Life expectancy of < 1 year;
26) Unable to complete the follow-up.

研究实施时间:

Study execute time:

From 2020-01-01 00:00:00 To 2022-01-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2020-01-01 00:00:00 To 2022-12-31 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

345

Group:

Control group

Sample size:

干预措施:

最佳药物治疗

干预措施代码:

Intervention:

optimal medication treatment

Intervention code:

组别:

FDA支架组

样本量:

345

Group:

FDA approved stenting group

Sample size:

干预措施:

被FDA批准用于治疗ICAS的支架植入联合最佳药物治疗

干预措施代码:

Intervention:

Stent implantation approved by the FDA for ICAS combined with optimal drug therapy

Intervention code:

组别:

非FDA支架组

样本量:

345

Group:

non-FDA approved stenting group

Sample size:

干预措施:

未被FDA批准用于治疗ICAS的支架植入联合最佳药物治疗组

干预措施代码:

Intervention:

Stent implantation unapproved by the FDA for ICAS combined with optimal drug therapy

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

第三军医大学新桥医院 

单位级别:

三甲 

Institution
hospital:

Xinqiao Hospital of the Third Military Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广州 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

南方医科大学珠江医院 

单位级别:

三甲 

Institution
hospital:

Zhujiang Hospital of Southern Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

青岛大学附属医院 

单位级别:

三甲 

Institution
hospital:

Qingdao University Affiliated Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东省千佛山医院 

单位级别:

三甲 

Institution
hospital:

Shandong Qianfoshan Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院 

单位级别:

三甲 

Institution
hospital:

Shandong University Qilu Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

四川大学华西医院 

单位级别:

三甲 

Institution
hospital:

West China Hospital of Sichuan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

四川省人民医院 

单位级别:

三甲 

Institution
hospital:

Sichuan provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第二医院 

单位级别:

三甲 

Institution
hospital:

Second Affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第三医院 

单位级别:

三甲 

Institution
hospital:

Third affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

吉林 

市(区县):

 

Country:

China

Province:

JiLin

City:

单位(医院):

吉林大学白求恩第一医院 

单位级别:

三甲 

Institution
hospital:

Bethune First Hospital of Jilin University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

武汉市中心医院 

单位级别:

三甲 

Institution
hospital:

Wuhan Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

吉林 

市(区县):

 

Country:

China

Province:

JiLin

City:

单位(医院):

吉林大学中日联谊医院 

单位级别:

三甲 

Institution
hospital:

China-Japan Friendship Hospital of Jilin University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

襄阳市第一人民医院 

单位级别:

三甲 

Institution
hospital:

The first People's Hospital of Xiangyang City

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

襄阳市中心医院 

单位级别:

三甲 

Institution
hospital:

Xiangyang Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hu'nan

City:

单位(医院):

湖南省人民医院 

单位级别:

三甲 

Institution
hospital:

Hunan Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China

Province:

Guandong

City:

单位(医院):

广东省人民医院 

单位级别:

三甲 

Institution
hospital:

Guangdong Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广西壮族自治区 

市(区县):

 

Country:

China

Province:

Guangxi Zhuang Autonomous Region

City:

单位(医院):

广西医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

云南 

市(区县):

 

Country:

China

Province:

Yunnan

City:

单位(医院):

昆明医科大学附属医院 

单位级别:

三甲 

Institution
hospital:

Kunming Medical University Affiliated Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

杭州市第一人民医院 

单位级别:

三甲 

Institution
hospital:

Hangzhou first People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

福建省立医院 

单位级别:

三甲 

Institution
hospital:

Fujian Provincial Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

陕西 

市(区县):

 

Country:

China

Province:

Shaan‘xi

City:

单位(医院):

西安交通大学第二附属医院 

单位级别:

三甲 

Institution
hospital:

Second Affiliated Hospital of Xi'an Jiaotong University

Level of the institution:

Tertiay A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

解放军福州总医院 

单位级别:

三甲 

Institution
hospital:

Fuzhou General Hospital of PLA

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽 

市(区县):

 

Country:

China

Province:

Anhui

City:

单位(医院):

安徽医科大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Anhui Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南京市脑科医院 

单位级别:

三甲 

Institution
hospital:

Nanjing Brain Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

入组后90天内的任何症状性卒中事件、短暂性脑缺血发作和死亡

指标类型:

主要指标

Outcome:

Any symptomatic stroke, TIA or death within 90 d

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后1年内的靶血管症状性卒中事件、TIA或死亡;

指标类型:

主要指标

Outcome:

Target Vessel Stroke, TIA or death event within 1 year

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后30天内的任何卒中事件、TIA或死亡

指标类型:

次要指标

Outcome:

Any symptomatic stroke, TIA or death within 30 d

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后30天内靶血管卒中事件、TIA或死亡

指标类型:

次要指标

Outcome:

Target Vessel Stroke event, TIA or death within 30 days

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

与支架植入术相关的并发症发生率(包括动脉破裂、动脉夹层、置入失败、支架折损、支架移位、血管穿刺点并发症如腹股沟血肿、血管痉挛等)

指标类型:

次要指标

Outcome:

procedural complications

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

基线及入组后90天和12个月NIHSS评分

指标类型:

次要指标

Outcome:

NIHSS score at baseline, 90 days and 1 year of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

基线及入组后30天、90天、6个月和12个月mRS评分

指标类型:

次要指标

Outcome:

mRS score at baseline, 30 days, 90 days, 6 months and 1 year of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后90天、12个月CTA评估支架内再狭窄率

指标类型:

次要指标

Outcome:

Stent restenosis within 90 daya and 1 years of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后90天、6个月、12个月与支架或药物治疗相关的心血管事件

指标类型:

次要指标

Outcome:

Cardiovascular events associated with stenting or drug withiin 90 days, 6 months, and 12 months of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后90天、6个月、12个月药物治疗的依从性

指标类型:

次要指标

Outcome:

Compliance with medication within 90 days, 6 months and 1 year of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

入组后12个月头颅MRI弥散张量成像(场强≤3.0T)各向异性值和平均弥散系数值

指标类型:

次要指标

Outcome:

Anisotropy and mean dispersion coefficient of MRI diffusion tensor imaging (intensity 3.0t) within 12 months of follow-up

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非出血性不良事件发生率(包括脑疝、肺炎、呼吸衰竭、循环衰竭、应激性溃疡、继发性癫痫、泌尿道感染、败血症、肾功能衰竭、静脉血栓形成及精神症状等)

指标类型:

次要指标

Outcome:

Incidence of non-hemorrhagic adverse events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 50 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究为观察性研究,没有对患者进行随机化分组,而是按照患者的治疗方案来进行分组

Randomization Procedure (please state who generates the random number sequence and by what method):

This is an observational study. Patients were not randomized into groups, but were grouped according to their treatment regimen

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

对评估者设盲

Blinding:

Blind method for evaluators.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

相关论文发表5年后在Resman平台公开原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Related papers published five years later, the IPD will be shared on ResMan.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

采用病例报告表(CRF)和临床病例资料电子数据采集系统(EDC)ResMan采集与管理数据

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Use Case Record Form (CRF) and Electronic Data Capture (EDC), ResMan to collect and manage data.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2019-11-17 20:21:52