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Post Marketing Study to Evaluate the NIMBUS Device

Post Marketing Study of Patients to Evaluate NIMBUS Revascularization Effectiveness With Challenging Occlusions

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT03898960
Acronym
SPERO
Enrollment
54
Registered
2019-04-02
Start date
2019-10-30
Completion date
2022-04-08
Last updated
2025-04-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cerebral Stroke

Brief summary

A post-market study evaluating the NIMBUS Device in acute ischemic stroke patients with confirmed intracranial large vessel occlusion.

Detailed description

The objective of this study is to assess the efficacy of the NIMBUS Device. The study will also report on clot characteristics and clinical outcomes.

Interventions

DEVICENIMBUS Device

NIMBUS Geometric Clot Extractor

Sponsors

Neuravi Limited
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Age ≥ 18 * The subject or the subject's legally authorized representative has signed and dated an Informed Consent Form. * Patient has had one or two passes of another mechanical thrombectomy device without achieving mTICI 2b or better and continues to have angiographic confirmation of a Large Vessel Occlusion (LVO) in the same vessel. * mRS 0-1 prior to this stroke. * NIMBUS is used on the second or third overall pass to attempt revascularization.

Exclusion criteria

* Currently participating in an investigational (drug, device, etc.) clinical trial that may confound study endpoints. Patients in observational, natural history, and/or epidemiological studies not involving intervention are eligible. * Confirmation of positive pregnancy test according to site specific standard of care (e.g. test, verbal communication). * All patients with severe hypertension on presentation (SBP \> 220 mmHg and/or DBP \> 120 mm Hg). All patients, in whom intravenous therapy with blood pressure medications is indicated, with hypertension that remains severe and sustained despite intravenous antihypertensive therapy (SBP \>185 mmHg and/ or DBP \>110 mmHg). * Known cerebral vasculitis. * Known cancer with life expectancy less than 12 months. * Stenosis, or any occlusion, in a proximal vessel that requires treatment or prevents access to the site of occlusion. * Intracranial stenosis that prevents access to the site of occlusion. * Computed tomography (CT) or Magnetic Resonance Imaging (MRI) evidence of recent/ fresh hemorrhage on presentation. * Baseline computed tomography (CT) or MRI showing mass effect or intracranial tumor (except small meningioma). * Evidence of dissection in the extra or intracranial cerebral arteries. * Occlusions in multiple vascular territories (e.g., bilateral anterior circulation, or anterior/posterior circulation).

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Successful Revascularization With NIMBUS DeviceDay 1Successful revascularization was defined as achieving an modified thrombolysis in cerebrovascular infarction (mTICI) score of 2b or greater as determined by an Independent Core Laboratory. The expanded treatment in cerebral infarction (eTICI) score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0 percent (%) filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in (67-89%) of downstream territory); 2c=Reperfusion in \[90-99%\] of downstream territory; 3=Complete and 100% reperfusion.

Secondary

MeasureTime frameDescription
Percentage of Participants With Successful Procedural RevascularizationDay 1Successful procedural revascularization was defined as achieving an mTICI score of 2b or greater at the end of procedure as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in \[90-99%\] of downstream territory; 3=Complete and 100% reperfusion.
Percentage of Participants With Excellent Procedural RevascularizationDay 1Excellent procedural revascularization was defined as achieving an mTICI score of 2c or greater at the end of procedure as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in (90-99%) of downstream territory; 3=Complete and 100% reperfusion.
Percentage of Participants With First Pass Revascularization Using NIMBUS DeviceDay 1First Pass revascularization was defined as achieving an mTICI score of 2b or greater after the first use of NIMBUS device as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in (90-99%) of downstream territory; 3=Complete and 100% reperfusion.
Percentage of Participants With Modified Rankin Scale (mRS) Score of Less Than or Equal to (<=) 2Up to Day 90Percentage of participants with mRS score of \<=2 was reported. The mRS was a 7-point scale that ranged from 0 to 6 where 0=no symptoms at all; 1=no significant disability despite symptoms; 2=slight disability; 3=moderate disability; 4=moderately severe disability; 5=severe disability; 6=death.
Percentage of Participants With Symptomatic Intracerebral Hemorrhage (sICH) According to the Heidelberg Bleeding Classification (HBC)Day 1Percentage of participants with sICH according to the HBC was reported. sICH was defined as new intracranial hemorrhage detected by brain imaging associated with any of the item: greater than or equal to (\>=) 4 points total National Institute of Health Stroke Scale (NIHSS) at the time of diagnosis compared to immediately before worsening; \>=2 point in one NIHSS category. The rationale for this was to capture new hemorrhages that produce new neurological symptoms, making them clearly symptomatic but not causing worsening in the original stroke territory; leading to intubation/hemicraniectomy/external ventricular drain (EVD) placement or other major medical/surgical intervention; absence of alternative explanation for deterioration.
Number of Participants With All-Cause MortalityUp to Day 90Number of participants with all-cause mortality at 90 days post-procedure on Day 0 was reported. All-cause mortality included all deaths of participants due to any cause.
Percentage of Participants With Embolization to a New Territory (ENT)Day 1Percentage of participants with ENT was reported.

Countries

Germany, Sweden

Participant flow

Participants by arm

ArmCount
Mechanical Thrombectomy: NIMBUS Device
Participants with acute ischemic stroke who had post one or two unsuccessful passes of another mechanical thrombectomy therapy and did not achieve modified thrombolysis in cerebrovascular infarction (mTICI) 2b or better, were treated with NIMBUS device.
54
Total54

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath10

Baseline characteristics

CharacteristicMechanical Thrombectomy: NIMBUS Device
Age, Continuous71.9 Years
STANDARD_DEVIATION 14.09
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
13 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
33 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
1 Participants
Race (NIH/OMB)
Black or African American
0 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
31 Participants
Race (NIH/OMB)
White
22 Participants
Sex: Female, Male
Female
27 Participants
Sex: Female, Male
Male
27 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
10 / 54
other
Total, other adverse events
6 / 54
serious
Total, serious adverse events
21 / 54

Outcome results

Primary

Percentage of Participants With Successful Revascularization With NIMBUS Device

Successful revascularization was defined as achieving an modified thrombolysis in cerebrovascular infarction (mTICI) score of 2b or greater as determined by an Independent Core Laboratory. The expanded treatment in cerebral infarction (eTICI) score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0 percent (%) filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in (67-89%) of downstream territory); 2c=Reperfusion in \[90-99%\] of downstream territory; 3=Complete and 100% reperfusion.

Time frame: Day 1

Population: The modified intent-to-treat (mITT) analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device). Here 'N' (number of participants analyzed) signifies number of participants who were evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Successful Revascularization With NIMBUS Device68.6 Percentage of participants
Secondary

Number of Participants With All-Cause Mortality

Number of participants with all-cause mortality at 90 days post-procedure on Day 0 was reported. All-cause mortality included all deaths of participants due to any cause.

Time frame: Up to Day 90

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Mechanical Thrombectomy: NIMBUS DeviceNumber of Participants With All-Cause Mortality10 Participants
Secondary

Percentage of Participants With Embolization to a New Territory (ENT)

Percentage of participants with ENT was reported.

Time frame: Day 1

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device).

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Embolization to a New Territory (ENT)0 Percentage of participants
Secondary

Percentage of Participants With Excellent Procedural Revascularization

Excellent procedural revascularization was defined as achieving an mTICI score of 2c or greater at the end of procedure as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in (90-99%) of downstream territory; 3=Complete and 100% reperfusion.

Time frame: Day 1

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device). Here 'N' (number of participants analyzed) signifies number of participants who were evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Excellent Procedural Revascularization37.7 Percentage of participants
Secondary

Percentage of Participants With First Pass Revascularization Using NIMBUS Device

First Pass revascularization was defined as achieving an mTICI score of 2b or greater after the first use of NIMBUS device as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in (90-99%) of downstream territory; 3=Complete and 100% reperfusion.

Time frame: Day 1

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device). Here 'N' (number of participants analyzed) signifies number of participants who were evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With First Pass Revascularization Using NIMBUS Device52.9 Percentage of participants
Secondary

Percentage of Participants With Modified Rankin Scale (mRS) Score of Less Than or Equal to (<=) 2

Percentage of participants with mRS score of \<=2 was reported. The mRS was a 7-point scale that ranged from 0 to 6 where 0=no symptoms at all; 1=no significant disability despite symptoms; 2=slight disability; 3=moderate disability; 4=moderately severe disability; 5=severe disability; 6=death.

Time frame: Up to Day 90

Population: The mRS analysis set consisted of all mITT participants who met study criteria as MRI criterion: volume of diffusion restriction visually assessed \<=50 milliliter(mL), computed tomography(CT) criterion: ASPECTS 6 to 10 on baseline CT, computed tomography angiography(CTA)-source images or volume of significantly lowered cerebral blood volume(CBV) \<=50 mL; NIHSS \>=8 and less than (\<)30; participants treated within 6 hours of onset of stroke symptoms (start of treatment defined as groin puncture).

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Modified Rankin Scale (mRS) Score of Less Than or Equal to (<=) 246.7 Percentage of participants
Secondary

Percentage of Participants With Successful Procedural Revascularization

Successful procedural revascularization was defined as achieving an mTICI score of 2b or greater at the end of procedure as determined by an Independent Core Laboratory. The eTICI score was a modified from the mTICI scale. eTICI was a 6-point grading system for determining the response of thrombolytic therapy for ischemic stroke: 0=No reperfusion; 0% filling of the downstream territory; 1=Thrombus reduction without any reperfusion of distal arteries; 2a=Reperfusion in less than half (1-49%) of the territory; 2b=2b50 (reperfusion in \[50-66%\] of downstream territory) and 2b67 (reperfusion in \[67-89%\] of downstream territory); 2c=Reperfusion in \[90-99%\] of downstream territory; 3=Complete and 100% reperfusion.

Time frame: Day 1

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device). Here 'N' (number of participants analyzed) signifies number of participants who were evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Successful Procedural Revascularization79.2 Percentage of participants
Secondary

Percentage of Participants With Symptomatic Intracerebral Hemorrhage (sICH) According to the Heidelberg Bleeding Classification (HBC)

Percentage of participants with sICH according to the HBC was reported. sICH was defined as new intracranial hemorrhage detected by brain imaging associated with any of the item: greater than or equal to (\>=) 4 points total National Institute of Health Stroke Scale (NIHSS) at the time of diagnosis compared to immediately before worsening; \>=2 point in one NIHSS category. The rationale for this was to capture new hemorrhages that produce new neurological symptoms, making them clearly symptomatic but not causing worsening in the original stroke territory; leading to intubation/hemicraniectomy/external ventricular drain (EVD) placement or other major medical/surgical intervention; absence of alternative explanation for deterioration.

Time frame: Day 1

Population: The mITT analysis set consisted of all participants who were enrolled into the study, and who had attempted at least one pass with the NIMBUS device (which included deployment and retrieval with the NIMBUS device).

ArmMeasureValue (NUMBER)
Mechanical Thrombectomy: NIMBUS DevicePercentage of Participants With Symptomatic Intracerebral Hemorrhage (sICH) According to the Heidelberg Bleeding Classification (HBC)3.7 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026