The unruptured aneurysm question needs a definitive trial.
IUAT is a planned multicentre, randomised, open-label, blinded-endpoint trial comparing surgical clipping with contemporary endovascular treatment for unruptured anterior circulation intracranial aneurysms.
Current status: planning, protocol refinement, CTU partnership and funding development. Not yet open for patient recruitment.
Why IUAT?
Unruptured aneurysms are increasingly detected, but clinicians still lack robust randomised evidence for the central treatment decision: clipping or endovascular treatment.
Read the rationaleTreatment versus observation failed to recruit
IUAT uses the deliverable treatment-versus-treatment question.
Clip versus EVT is recruitable, but the evidence remains incomplete
The pilot did not test the full modern endovascular portfolio.
PRAEMIUM provides contemporary surgical risk benchmarks
These data help power a rigorous new study.
Contemporary EVT, patient-centred outcomes and blinded adjudication
A strategy trial designed around clinical equipoise and outcomes that matter to elective patients.
For interested physicians and centres
IUAT is seeking neurovascular centres where both clipping and contemporary endovascular treatment are technically feasible and clinically reasonable for eligible patients.
Design
PROBE randomised trial
Multicentre, prospective, randomised, open-label, blinded-endpoint design with 1:1 allocation.
Comparator
Full contemporary EVT portfolio
Conventional coiling, balloon-assisted coiling, stent-assisted coiling, intrasaccular devices and flow diversion where appropriate.
Endpoint
Hierarchical win ratio
Safety first, then COSMOS patient-centred function, then recovery trajectory.