This is a prospective, open-label, consecutive enrollment, multi-center, U.S. registry of patients with intracranial aneurysms who are treated with the Optima Coil System. The primary objective of this registry is to evaluate the safety and effectiveness of the OptimaTM Coil System, including the OptiMAX Coils, in the real-world treatment of intracranial aneurysms. Imaging will be analyzed by a designated core neuroimaging lab to assess procedural success and aneurysm occlusion rates. Intent to treat population total: 700 patients 600 patients, up to 100 screen failures.
The primary objective of this registry is to evaluate the safety and effectiveness of the OptimaTM Coil System, including the OptiMAX Coils, in the real-world treatment of intracranial aneurysms. Imaging will be analyzed by a designated core neuroimaging lab to assess procedural success and aneurysm occlusion rates. The core lab will consist of 4-5 physicians, 2-3 from within HCA Healthcare, and 2-3 from outside of HCA Healthcare. Core lab physicians will be blinded to patient characteristics for HIPAA compliance. Physicians within the core lab will not be principal investigators enrolling patients in the study. 600 subjects with intracranial saccular aneurysms (maximum dimension ≤ 24 mm), ruptured or unruptured, treated with the OptimaTM Coil System. As this is a registry, there will be no formal hypothesis testing of the study endpoints, and no formal sample size / power calculations will be performed. Approximately 600 subjects will be enrolled in the registry at up to 12 clinical sites in the US. Data analyses will be performed and led by the study PIs, Site PIs, and Sub-investigators. Expected descriptive statistics will include baseline patient demographics, procedural characteristics, radiographic parameters, safety outcomes, clinical and efficacy outcomes. Pilot univariate and multivariate logistic regression will be performed on the intention-to-treat cohort to identify predictors of adequate and complete aneurysm occlusion.
Study Type
OBSERVATIONAL
Enrollment
600
\*Percentage from protocol
Med City Plano
Plano, Texas, United States
RECRUITINGMeasure Adequate Occlusion Using modified Raymond-Roy Occlusion Class (MRRC) I and II score
Rated by a designated core lab without retreatment as confirmed by core lab adjudication.
Time frame: 1 year follow up +/- 90 days
Assess coiling alone or in combination with adjunctive devices for approximately 400 patients
Subgroup using adjunctive devices include including balloon remodeling and stenting
Time frame: 1 year follow up +/- 90 days
Evaluate Coiling with flow diversion for approximately 200 subjects
Subgroup utilizing flow diverter for approximately 200 subjects
Time frame: 1 year follow up +/- 90 days
Subgroup analyses will be performed examining:
Aneurysms treated predominantly (≥50%) with Balt manufactured coils will also be analyzed for the number of coils utilized per aneurysm and procedure duration
Time frame: 1 year follow up +/- 90 days
Analyze outcomes of small aneurysms defined as smaller than 5mm
Outcomes of small aneurysms defined as smaller than 5mm
Time frame: 1 year follow up +/- 90 days
Adequate occlusion
Confirmed by core lab adjudication.
Time frame: Immediate Post Procedure
Packing density
The percentage of coil volume to aneurysm volume using AngioSuite.
Time frame: Day 1
Complete occlusion
Utilizing MRRC Class I
Time frame: 1 Year post- procedure
Complete occlusion
Utilizing MRRC Class 1
Time frame: Immediate post procedure
Recanalization rate
Any worsening in aneurysm occlusion on the MRRC scale
Time frame: 1 year post procedure
Retreatment rate
Retreatment of Target aneurysm
Time frame: 1 year post procedure
Change in degree of disability
The proportion of patients with modified Rankin Scale score 0-2 (or at baseline score if \>2)
Time frame: 1 year post procedure
The number of coils used in an aneurysm
The number of coils used in an aneurysm stratified by aneurysm size.
Time frame: Upon enrollment
Procedural fluoroscopic time
Procedural fluoroscopic time
Time frame: During procedure
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