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NCT04129125

The Imperative Trial: Treatment of Acute Ischemic Stroke With the Zoom Reperfusion System

Completed NA Results posted Last updated 8 August 2025
What this trial tests

NA trial testing Zoom Reperfusion System in Ischemic Stroke in 328 participants. Completed in 28 May 2024.

Timeline
1 October 2021
Primary endpoint
28 May 2024
28 May 2024

Quick facts

Lead sponsorImperative Care, Inc.
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment328
Start date1 October 2021
Primary completion28 May 2024
Estimated completion28 May 2024
Sites28 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Imperative Care, Inc. — full company profile →

Who can join

18 and older, any sex, with Ischemic Stroke or Acute Stroke. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

ITT Cohort: Rate of Core Lab-adjudicated Reperfusion Success Primary · Intraprocedural

Reperfusion success was defined as achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2b within three or fewer passes using the study device and without rescue therapy (e.g., additional thrombectomy devices or intra-arterial lytics). The mTICI scale ranges from 0 to 3, with higher scores indicating better reperfusion: 0 = no perfusion, 1 = minimal perfusion, 2a = partial (\<50%), 2b = substantial (≥50%), 2c = near complete, 3 = complete. This measure reports the number of participants who achieved mTICI ≥2b under these criteria as adjudicated by an independent core lab.

GroupValue95% CI
Zoom Reperfusion System216
ITT Cohort: Rate of Symptomatic Intracranial Hemorrhage (sICH), as Independently Adjudicated by Core Lab and Safety Board Primary · 24-hour post-procedure

Rate of symptomatic intracranial hemorrhage (sICH), as independently adjudicated by the core lab and the independent safety board

GroupValue95% CI
Zoom Reperfusion System5
FDA Clearance Cohort: Rate of Core Lab-adjudicated Reperfusion Success Primary · Intraprocedural

Reperfusion success was defined as achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2b within three or fewer passes using the study device and without rescue therapy (e.g., additional thrombectomy devices or intra-arterial lytics). The mTICI scale ranges from 0 to 3, with higher scores indicating better reperfusion: 0 = no perfusion, 1 = minimal perfusion, 2a = partial (\<50%), 2b = substantial (≥50%), 2c = near complete, 3 = complete. This measure reports the number of participants who achieved mTICI ≥2b under these criteria as adjudicated by an independent core lab.

GroupValue95% CI
Zoom Reperfusion System177
FDA Clearance Cohort: Rate of Symptomatic Intracranial Hemorrhage (sICH), as Independently Adjudicated by Core Lab and Safety Board Primary · 24-hour post-procedure

Rate of symptomatic intracranial hemorrhage (sICH), as independently adjudicated by the core lab and the independent safety board

GroupValue95% CI
Zoom Reperfusion System2
FDA Clearance Cohort for Distal ICA/M1 Occlusions: Rate of Core Lab-adjudicated Reperfusion Success Primary · Intraprocedural

Reperfusion success was defined as achieving a modified Treatment in Cerebral Infarction (mTICI) score of ≥2b within three or fewer passes using the study device and without rescue therapy (e.g., additional thrombectomy devices or intra-arterial lytics). The mTICI scale ranges from 0 to 3, with higher scores indicating better reperfusion: 0 = no perfusion, 1 = minimal perfusion, 2a = partial (\<50%), 2b = substantial (≥50%), 2c = near complete, 3 = complete. This measure reports the number of participants who achieved mTICI ≥2b under these criteria as adjudicated by an independent core lab.

GroupValue95% CI
Zoom Reperfusion System125
FDA Clearance Cohort for Distal ICA/M1 Occlusions: Rate of Symptomatic Intracranial Hemorrhage (sICH), as Independently Adjudicated by Core Lab and Safety Board Primary · 24-hour post-procedure

Rate of symptomatic intracranial hemorrhage (sICH), as independently adjudicated by the core lab and the independent safety board

GroupValue95% CI
Zoom Reperfusion System1
ITT Cohort: Time to Achieve mTICI Score ≥ 2b Secondary · Intraprocedural

The time from groin puncture to mTICI (modified treatment in cerebral infarction) score ≥ 2b mTICI range: 0 to 3; higher score means better reperfusion

GroupValue95% CI
Zoom Reperfusion System1913 – 30
ITT Cohort: Rate of mTICI Score 3 Reperfusion Secondary · Intraprocedural

Independent core lab-adjudicated reperfusion success, defined as modified treatment in cerebral infarction (mTICI) score = 3 within three or fewer passes with the study device, without using rescue therapy (e.g., additional thrombectomy devices or intra-arterial lytics) mTICI range: 0 to 3; higher score means better reperfusion

GroupValue95% CI
Zoom Reperfusion System78
ITT Cohort: Rate of First Pass Success Secondary · Intraprocedural

Independent core lab-adjudicated modified treatment in cerebral infarction (mTICI) score ≥2b after the first pass with the study device mTICI range: 0 to 3; higher score means better outcome

GroupValue95% CI
Zoom Reperfusion System148
ITT Cohort: Rate of mTICI Score 2c Reperfusion Secondary · Intraprocedural

Independent core lab-adjudicated reperfusion success, defined as modified treatment in cerebral infarction (mTICI) score ≥2c within three or fewer passes with the study device, without using rescue therapy (e.g., additional thrombectomy devices or intra-arterial lytics) mTICI range: 0 to 3; higher score means better outcome

GroupValue95% CI
Zoom Reperfusion System147
ITT Cohort: Rate of Functional Independence Secondary · 90-days post-procedure

The proportion of patients achieving modified Rankin Scale (mRS) score ≤2 using the primary treatment modality, evaluated by certified assessors The mRS scale ranges from 0 (no symptoms) to 5 (severe disability), with an additional category of 6 for death

GroupValue95% CI
Zoom Reperfusion System133
ITT Cohort: Quality of Life Assessment Secondary · 90 days post-procedure

The Stroke Impact Scale (SIS) is a self-reported questionnaire assessing quality of life in 8 domains: Strength, Memory and Thinking, Emotion, Communication, ADL/IADL, Mobility, Hand Function, and Participation/Role Function. Each domain is scored from 0 to 100, with higher scores indicating better function and less impact of stroke. Scores are calculated by averaging item responses in each domain and transforming to a 0-100 scale. A separate recovery score from 0 (no recovery) to 100 (full recovery) reflects the patient's overall perception of recovery. Domain scores are not combined into a t

Overall Recovery
GroupValue95% CI
Zoom Reperfusion System71.5± 25.8
Strength
GroupValue95% CI
Zoom Reperfusion System71± 27.9
Memory and Thinking
GroupValue95% CI
Zoom Reperfusion System79.9± 21.9
Emotion
GroupValue95% CI
Zoom Reperfusion System78.9± 17.9
Communication
GroupValue95% CI
Zoom Reperfusion System85± 22.6
Activities of Daily Living or Instrumental Activities of Daily Living
GroupValue95% CI
Zoom Reperfusion System76.3± 28.5
Mobility
GroupValue95% CI
Zoom Reperfusion System71.5± 29.5
Hand Function
GroupValue95% CI
Zoom Reperfusion System68.9± 36

Adverse events — posted to ClinicalTrials.gov

Time frame: Throughout 90 days post-procedure. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Zoom Reperfusion System
Serious: 95/260 (37%)
Deaths: 33/260

Serious adverse events (20 terms)

ReactionSystemZoom Reperfusion System
Acute respiratory failureRespiratory, thoracic and mediastinal disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
Brain oedemaNervous system disorders
PneumoniaInfections and infestations
Cerebrovascular accidentNervous system disorders
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders
Haemorrhagic transformation strokeNervous system disorders
Cardiac arrestCardiac disorders
Cardiac failure acuteCardiac disorders
DysphagiaGastrointestinal disorders
Gastrointestinal haemorrhageGastrointestinal disorders
Urinary tract infectionInfections and infestations
Cerebral artery restenosisNervous system disorders
Cerebral haemorrhageNervous system disorders
SeizureNervous system disorders
Atrial fibrillationCardiac disorders
Cardiac failureCardiac disorders
Vascular pseudoaneurysmInjury, poisoning and procedural complications
Vessel perforationInjury, poisoning and procedural complications
Cerebral artery occlusionNervous system disorders
Other adverse events (30 terms — click to expand)

ReactionSystemZoom Reperfusion System
Atrial fibrillationCardiac disorders
Urinary tract infectionInfections and infestations
HypokalaemiaMetabolism and nutrition disorders
Urinary retentionRenal and urinary disorders
PneumoniaInfections and infestations
Haemorrhage intracranialNervous system disorders
LeukocytosisBlood and lymphatic system disorders
Acute kidney injuryRenal and urinary disorders
HypernatraemiaMetabolism and nutrition disorders
Pulmonary oedemaRespiratory, thoracic and mediastinal disorders
HypertensionVascular disorders
HypotensionVascular disorders
Cerebral haemorrhageNervous system disorders
HeadacheNervous system disorders
DysphagiaGastrointestinal disorders
NauseaGastrointestinal disorders
Haemorrhagic transformation strokeNervous system disorders
Subarachnoid haemorrhageNervous system disorders
AgitationPsychiatric disorders
AnaemiaBlood and lymphatic system disorders
FallInjury, poisoning and procedural complications
Cerebral vasoconstrictionNervous system disorders
ThrombocytopeniaBlood and lymphatic system disorders
HyperglycaemiaMetabolism and nutrition disorders
HypomagnesaemiaMetabolism and nutrition disorders
HypophosphataemiaMetabolism and nutrition disorders
Brain oedemaNervous system disorders
Cerebral microhaemorrhageNervous system disorders
SeizureNervous system disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: Acute respiratory failure, Respiratory failure, Brain oedema, Pneumonia, Cerebrovascular accident, Pneumonia aspiration, Haemorrhagic transformation stroke, Cardiac arrest.

Data from ClinicalTrials.gov NCT04129125 adverse events section.

Sponsor's own description

The trial is designed to assess the safety and efficacy of using the Zoom Reperfusion System in subjects diagnosed with acute ischemic stroke and undergoing a thrombectomy procedure within 8 hours of last known well.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Stroke thrombectomy with a novel reperfusion system including a 0.088'' aspiration catheter: the Imperative Trial.
    Mack W, De Leacy RA, Grossberg JA, Majidi S, et al · · 2026 · cited 2× · PMID 40695608 · DOI 10.1136/jnis-2025-023719
  2. Unmet Needs in Acute Ischemic Stroke: Overcoming Recalcitrant Clots.
    Mirza M, Ulfert C, Ulfert C, McCarthy R, et al · · 2025 · PMID 40576345 · DOI 10.1097/crd.0000000000000977

Verify or expand the search:

Other recruiting trials for Ischemic Stroke

Currently open trials in the same condition.

Other Imperative Care, Inc. trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04129125.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing