Document Detail


Study design of the CLOSURE I Trial: a prospective, multicenter, randomized, controlled trial to evaluate the safety and efficacy of the STARFlex septal closure system versus best medical therapy in patients with stroke or transient ischemic attack due to presumed paradoxical embolism through a patent foramen ovale.
MedLine Citation:
PMID:  21051670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Some strokes of unknown etiology may be the result of a paradoxical embolism traversing through a nonfused foramen ovale (patent foramen ovale [PFO]). The utility of percutaneously placed devices for treatment of patients with cryptogenic stroke or transient ischemic attack (TIA) and PFO is unknown. In addition, there are no clear data about the utility of medical interventions or other surgical procedures in this situation. Despite limited data, many patients are being treated with PFO closure devices. Thus, there is a strong need for clinical trials that test the potential efficacy of PFO occlusive devices in this situation. To address this gap in medical knowledge, we designed the CLOSURE I trial, a randomized, clinical trial comparing the use of a percutaneously placed PFO occlusive device and best medical therapy versus best medical therapy alone for prevention of recurrent ischemic neurologic symptoms among persons with TIA or ischemic stroke.
STUDY DESIGN: This prospective, multicenter, randomized, controlled trial has finished enrollment. Two-year follow-up for all 910 patients is required. The primary end point is the 2-year incidence of stroke or TIA, all-cause mortality for the first 30 days, and neurologic mortality from ≥ 31 days of follow-up, as adjudicated by a panel of physicians who are unaware of treatment allocation. This article describes the rationale and study design of CLOSURE I.
CONCLUSIONS: This trial should provide information as to whether the STARFlex septal closure system is safe and more effective than best medical therapy alone in preventing recurrent stroke/TIA and mortality in patients with PFO and whether the STARFlex septal closure device can demonstrate superiority compared with best medical therapy alone. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00201461.
Authors:
Anthony J Furlan; Mark Reisman; Joseph Massaro; Laura Mauri; Harold Adams; Gregory W Albers; Robert Felberg; Howard Herrmann; Saibal Kar; Michael Landzberg; Albert Raizner; Lawrence Wechsler;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-11-04
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-22     Revised Date:  2011-01-25    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2872-83     Citation Subset:  IM    
Affiliation:
Department of Neurology, Neurological Institute-Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. Anthony.Furlan@UHhospitals.org
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00201461
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation Disorders / blood,  complications
Echocardiography, Transesophageal
Endpoint Determination
Follow-Up Studies
Foramen Ovale, Patent / complications*
Humans
Intracranial Embolism / complications*
Ischemic Attack, Transient / etiology,  therapy*
Laboratory Techniques and Procedures
Migraine Disorders / complications
Prospective Studies
Recurrence / prevention & control
Research Design
Sample Size
Stents* / adverse effects
Stroke / etiology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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