Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
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 endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03494920
Registration number
NCT03494920
Ethics application status
Date submitted
4/04/2018
Date registered
11/04/2018
Date last updated
16/06/2022
Titles & IDs
Public title
DIRECT-SAFE: A Randomized Controlled Trial of DIRECT Endovascular Clot Retrieval Versus Standard Bridging Thrombolysis With Endovascular Clot Retrieval
Query!
Scientific title
DIRECT-SAFE: A Randomized Controlled Trial of DIRECT Endovascular Clot Retrieval Versus Standard Bridging Thrombolysis With Endovascular Clot Retrieval Within 4.5 Hours of Stroke Onset
Query!
Secondary ID [1]
0
0
NTA1601
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Ischemic Stroke
0
0
Query!
Condition category
Condition code
Stroke
0
0
0
0
Query!
Haemorrhagic
Query!
Stroke
0
0
0
0
Query!
Ischaemic
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Other interventions - Direct endovascular clot retrieval
Other interventions - Bridging thrombolysis followed by ECR
Other: Direct endovascular clot retrieval - Endovascular clot retrieval (ECR) within 4.5 hours stroke
Other: Bridging thrombolysis followed by ECR - Intravenous tPA (at the standard licensed dose of 0.9 mg/kg up to a maximum of 90mg, 10% as bolus and the remainder over 1 hour) followed by ECR
Other interventions: Direct endovascular clot retrieval
Direct endovascular clot retrieval within 4.5 hours of stroke onset
Other interventions: Bridging thrombolysis followed by ECR
Bridging thrombolysis followed by ECR within 4.5 hours of stroke onset
Query!
Intervention code [1]
0
0
Other interventions
Query!
Comparator / control treatment
Query!
Control group
Query!
Outcomes
Primary outcome [1]
0
0
Modified Rankin Scale (mRS)- ordinal analysis
Query!
Assessment method [1]
0
0
Modified Rankin Scale (mRS) 0-2 or no change from baseline
Query!
Timepoint [1]
0
0
3 months
Query!
Secondary outcome [1]
0
0
modified Rankin Scale (mRS)- ordinal analysis
Query!
Assessment method [1]
0
0
mRS 0-1 or no change from baseline
Query!
Timepoint [1]
0
0
3 months
Query!
Secondary outcome [2]
0
0
Death
Query!
Assessment method [2]
0
0
Death due to any cause
Query!
Timepoint [2]
0
0
3 months
Query!
Secondary outcome [3]
0
0
Angiographic reperfusion
Query!
Assessment method [3]
0
0
Proportion of patients with good angiographic reperfusion (mTICI 2b-3)
Query!
Timepoint [3]
0
0
Baseline
Query!
Secondary outcome [4]
0
0
Symptomatic intracranial haemorrhage (sICH)
Query!
Assessment method [4]
0
0
Proportion of patients with sICH
Query!
Timepoint [4]
0
0
24 hours
Query!
Eligibility
Key inclusion criteria
1. Patients presenting with acute ischemic stroke eligible using standard criteria to receive IV thrombolysis within 4.5 hours of stroke onset
2. Patient's age is =18 years
3. Intra-arterial clot retrieval treatment can commence (groin puncture) within 6 hours of stroke onset.
4. Arterial occlusion on CTA or MRA of the ICA, M1, M2 or basilar artery
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
1. Intracranial hemorrhage (ICH) identified by CT or MRI
2. Rapidly improving symptoms at the discretion of the investigator
3. Pre-stroke mRS score of = 4 (indicating previous disability)
4. Hypodensity in >1/3 MCA territory on non-contrast CT
5. Contra indication to imaging with contrast agents
6. Any terminal illness such that patient would not be expected to survive more than 1 year
7. Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study.
8. Pregnant women
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people assessing the outcomes
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 3
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Data analysis
Query!
Reason for early stopping/withdrawal
Query!
Other reasons
Query!
Date of first participant enrolment
Anticipated
Query!
Actual
27/04/2018
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
8/09/2021
Query!
Sample size
Target
Query!
Accrual to date
Query!
Final
295
Query!
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
Query!
Recruitment hospital [1]
0
0
Liverpool Hospital - Liverpool
Query!
Recruitment hospital [2]
0
0
John Hunter Hospital - New Lambton
Query!
Recruitment hospital [3]
0
0
Royal North Shore Hospital - St Leonards
Query!
Recruitment hospital [4]
0
0
Royal Brisbane & Women's Hospital - Brisbane
Query!
Recruitment hospital [5]
0
0
Gold Coast University Hospital - Gold Coast
Query!
Recruitment hospital [6]
0
0
Princess Alexandra Hospital - Woolloongabba
Query!
Recruitment hospital [7]
0
0
Royal Adelaide Hospital - Adelaide
Query!
Recruitment hospital [8]
0
0
Monash Medical Centre - Clayton
Query!
Recruitment hospital [9]
0
0
Mobile Stroke Unit - Melbourne
Query!
Recruitment hospital [10]
0
0
Royal Melbourne Hospital - Melbourne
Query!
Recruitment hospital [11]
0
0
Fiona Stanley Hospital - Murdoch
Query!
Recruitment hospital [12]
0
0
Sir Charles Gairdner Hospital - Nedlands
Query!
Recruitment postcode(s) [1]
0
0
2170 - Liverpool
Query!
Recruitment postcode(s) [2]
0
0
2305 - New Lambton
Query!
Recruitment postcode(s) [3]
0
0
2605 - St Leonards
Query!
Recruitment postcode(s) [4]
0
0
- Brisbane
Query!
Recruitment postcode(s) [5]
0
0
4215 - Gold Coast
Query!
Recruitment postcode(s) [6]
0
0
4102 - Woolloongabba
Query!
Recruitment postcode(s) [7]
0
0
5000 - Adelaide
Query!
Recruitment postcode(s) [8]
0
0
3168 - Clayton
Query!
Recruitment postcode(s) [9]
0
0
3050 - Melbourne
Query!
Recruitment postcode(s) [10]
0
0
- Melbourne
Query!
Recruitment postcode(s) [11]
0
0
6150 - Murdoch
Query!
Recruitment postcode(s) [12]
0
0
6009 - Nedlands
Query!
Recruitment outside Australia
Country [1]
0
0
China
Query!
State/province [1]
0
0
Guangdong
Query!
Country [2]
0
0
China
Query!
State/province [2]
0
0
Hebei
Query!
Country [3]
0
0
China
Query!
State/province [3]
0
0
Hubei
Query!
Country [4]
0
0
China
Query!
State/province [4]
0
0
Liaoning
Query!
Country [5]
0
0
China
Query!
State/province [5]
0
0
Shandong
Query!
Country [6]
0
0
China
Query!
State/province [6]
0
0
Taiyuan
Query!
Country [7]
0
0
China
Query!
State/province [7]
0
0
Beijing
Query!
Country [8]
0
0
China
Query!
State/province [8]
0
0
Hunan
Query!
Country [9]
0
0
China
Query!
State/province [9]
0
0
Jilin
Query!
Country [10]
0
0
China
Query!
State/province [10]
0
0
Maoming
Query!
Country [11]
0
0
China
Query!
State/province [11]
0
0
Shunde
Query!
Country [12]
0
0
China
Query!
State/province [12]
0
0
Taizhou
Query!
Country [13]
0
0
China
Query!
State/province [13]
0
0
Tianjin
Query!
Country [14]
0
0
Singapore
Query!
State/province [14]
0
0
Singapore
Query!
Country [15]
0
0
Vietnam
Query!
State/province [15]
0
0
Hanoi
Query!
Country [16]
0
0
Vietnam
Query!
State/province [16]
0
0
Ho Chi Minh City
Query!
Funding & Sponsors
Primary sponsor type
Other
Query!
Name
Neuroscience Trials Australia
Query!
Address
Query!
Country
Query!
Other collaborator category [1]
0
0
Other
Query!
Name [1]
0
0
The Florey Institute of Neuroscience and Mental Health
Query!
Address [1]
0
0
Query!
Country [1]
0
0
Query!
Ethics approval
Ethics application status
Query!
Summary
Brief summary
The study will be a multicentre, prospective, randomized, open label, blinded endpoint (PROBE) phase 3 trial (2 arm with 1:1 randomization) in ischemic stroke patients within 4.5 hours of stroke onset. Randomised patients will be stratified for site of baseline arterial occlusion into one of three groups: 1. internal carotid artery (ICA) 2. middle cerebral artery (MCA) 3. basilar artery (BA). Patients will be randomised to either bridging intravenous thrombolysis with endovascular clot retrieval (ECR), or direct endovascular clot retrieval.
Query!
Trial website
https://clinicaltrials.gov/study/NCT03494920
Query!
Trial related presentations / publications
Mitchell PJ, Yan B, Churilov L, Dowling RJ, Bush SJ, Bivard A, Huo XC, Wang G, Zhang SY, Ton MD, Cordato DJ, Kleinig TJ, Ma H, Chandra RV, Brown H, Campbell BCV, Cheung AK, Steinfort B, Scroop R, Redmond K, Miteff F, Liu Y, Duc DP, Rice H, Parsons MW, Wu TY, Nguyen HT, Donnan GA, Miao ZR, Davis SM; DIRECT-SAFE Investigators. Endovascular thrombectomy versus standard bridging thrombolytic with endovascular thrombectomy within 4.5 h of stroke onset: an open-label, blinded-endpoint, randomised non-inferiority trial. Lancet. 2022 Jul 9;400(10346):116-125. doi: 10.1016/S0140-6736(22)00564-5. Mitchell PJ, Yan B, Churilov L, Dowling RJ, Bush S, Nguyen T, Campbell BCV, Donnan GA, Miao Z, Davis SM; DIRECT-SAFE Investigators. DIRECT-SAFE: A Randomized Controlled Trial of DIRECT Endovascular Clot Retrieval versus Standard Bridging Therapy. J Stroke. 2022 Jan;24(1):57-64. doi: 10.5853/jos.2021.03475. Epub 2022 Jan 31.
Query!
Public notes
Query!
Contacts
Principal investigator
Name
0
0
Peter Mitchell, MD
Query!
Address
0
0
Melbourne Health
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for public queries
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03494920
Download to PDF