Ovine Graft (Omniflow II) Versus PTFE in Below Knee Arterial Reconstruction

NCT ID: NCT00845585

Last Updated: 2015-07-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2009-01-31

Study Completion Date

2015-01-31

Brief Summary

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The study intends to compare commonly used PTFE grafts with the biologic ovine graft Ominiflow II for below-knee bypass surgery in patients with peripheral artery occlusive disease with no autologous vein graft available. The hypothesis of this randomized trial is that that Omniflow II does not have a higher patency than PTFE over 36 months (one-sided test). An interim analysis will be performed at 18

Detailed Description

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Background

Despite advances in endovascular therapies, arterial bypass to restore blood flow to a patent distal artery often is the best option in the management of lower extremity occlusive arterial disease. The greater saphenous vein is the conduit of choice for infrainguinal reconstructions - but it is not always available or is otherwise unusable in a significant percentage of patients. In those situations, arterial reconstruction using prosthetic material is an option. Synthetic and biological vascular grafts have been used for some three decades. With time, synthetic conduits tend to increase their thrombogenic potential rather than diminish it by formation of neointima. Over time biological grafts have become alternatives to synthetic materials, mainly in the more demanding applications below the knee. For various reasons most biological grafts have been withdrawn from the market and Omniflow II (Bio Nova International, Mel-bourne, Australia) is currently the only biological vascular prosthesis available for peripheral revascularisation.

Objective

The Omniflow II prosthesis is a biosynthetic device formed from stabilised sheep collagen with an integral polyester mesh. It is produced by inserting polyester mesh-covered mandrels beneath the cutaneous trunci muscle of adult sheep for a period of 12-14 weeks. The collagen-encapsulated tubes are harvested and stabilised using glutaraldehyde. The design provides long-term structural stability of the prosthesis and compliance that is similar to that of an autologous artery. There are no randomised studies comparing the Omniflow II graft to either autologous vein or PTFE. Extensive in vivo testing has been performed for safety and efficacy. The Omniflow graft is registered in Europe, Australia, Canada and in a range of countries in South America and South East Asia.

Methods

All patients between the ages 20 to 90 with peripheral arterial disease with severe, life-style limiting claudication, rest pain or tissue lesions based on occlusion of the femoral or popliteal artery can be considered, if no suitable vein is available for the reconstruction in infrapopliteal reconstructions. Written consent is obtained from all volunteering patients including willingness to participate in the follow-up process. Primary end point of the study is primary patency, defined by duplex scan as freedom from binary restenosis of 50%.

Conditions

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Peripheral Arterial Occlusive Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Owniflow II

Group Type ACTIVE_COMPARATOR

Below Knee Arterial Reconstruction

Intervention Type DEVICE

Patency, Reinterventions, Amputations, mortality

PTFE

Group Type ACTIVE_COMPARATOR

Below Knee Arterial Reconstruction

Intervention Type DEVICE

Patency, Reinterventions, Amputations, mortality

Interventions

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Below Knee Arterial Reconstruction

Patency, Reinterventions, Amputations, mortality

Intervention Type DEVICE

Below Knee Arterial Reconstruction

Patency, Reinterventions, Amputations, mortality

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age between 20 to 90
* Peripheral arterial occlusive disease with life-style limitation, claudication, rest pain, tissue loss,
* No suitable vein for reconstruction available
* Written consent obtained

Exclusion Criteria

* Acute limb threatening ischaemia
* Patient younger than 20
* Pregnant women
* Myocardial infarction during past 30 days
* Stroke
* Life expectancy \< 1 year
Minimum Eligible Age

20 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Responsible Party

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Dept of Cardiovascular Surgery, University Hospital Bern

Principal Investigators

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Jürg Schmiedli, MD

Role: PRINCIPAL_INVESTIGATOR

Bern University Hospital

Locations

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Dept. of Cardiovascular Surgery

Bern, , Switzerland

Site Status

Countries

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Switzerland

References

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Schmidli J, Savolainen H, Heller G, Widmer MK, Then-Schlagau U, Baumgartner I, Carrel TP. Bovine mesenteric vein graft (ProCol) in critical limb ischaemia with tissue loss and infection. Eur J Vasc Endovasc Surg. 2004 Mar;27(3):251-3. doi: 10.1016/j.ejvs.2003.12.001.

Reference Type BACKGROUND
PMID: 14760592 (View on PubMed)

Miller JH, Foreman RK, Ferguson L, Faris I. Interposition vein cuff for anastomosis of prosthesis to small artery. Aust N Z J Surg. 1984 Jun;54(3):283-5. doi: 10.1111/j.1445-2197.1984.tb05318.x.

Reference Type BACKGROUND
PMID: 6380479 (View on PubMed)

Kal'noi MP, Mikhailichenko IuP, Alabovskii IuI, Mishin FI. [Experience in medical service to the population in mass agricultural operations in Ipatovo District]. Zdravookhr Ross Fed. 1979;(7):10-3. No abstract available. Russian.

Reference Type BACKGROUND
PMID: 157650 (View on PubMed)

Walluscheck KP, Bierkandt S, Brandt M, Cremer J. Infrainguinal ePTFE vascular graft with bioactive surface heparin bonding. First clinical results. J Cardiovasc Surg (Torino). 2005 Aug;46(4):425-30.

Reference Type BACKGROUND
PMID: 16160689 (View on PubMed)

Kersting S, Ockert D, Zimmermann T, Meichelbock W, Saeger HD, Bergert H. Infragenicular polytetrafluoroethylene bypass with tapered versus straight vascular grafts: results from a prospective multicenter cohort study. Ann Vasc Surg. 2004 Jul;18(4):440-7. doi: 10.1007/s10016-004-0052-3.

Reference Type BACKGROUND
PMID: 15164262 (View on PubMed)

Panneton JM, Hollier LH, Hofer JM. Multicenter randomized prospective trial comparing a pre-cuffed polytetrafluoroethylene graft to a vein cuffed polytetrafluoroethylene graft for infragenicular arterial bypass. Ann Vasc Surg. 2004 Mar;18(2):199-206. doi: 10.1007/s10016-004-0012-y.

Reference Type BACKGROUND
PMID: 15253256 (View on PubMed)

Jensen LP, Lepantalo M, Fossdal JE, Roder OC, Jensen BS, Madsen MS, Grenager O, Fasting H, Myhre HO, Baekgaard N, Nielsen OM, Helgstrand U, Schroeder TV. Dacron or PTFE for above-knee femoropopliteal bypass. a multicenter randomised study. Eur J Vasc Endovasc Surg. 2007 Jul;34(1):44-9. doi: 10.1016/j.ejvs.2007.01.016. Epub 2007 Apr 2.

Reference Type BACKGROUND
PMID: 17400486 (View on PubMed)

Koch G, Gutschi S, Pascher O, Fruhwirth H, Glanzer H. Analysis of 274 Omniflow Vascular Prostheses implanted over an eight-year period. Aust N Z J Surg. 1997 Sep;67(9):637-9. doi: 10.1111/j.1445-2197.1997.tb04614.x.

Reference Type BACKGROUND
PMID: 9322703 (View on PubMed)

Diehm N, Baumgartner I, Jaff M, Do DD, Minar E, Schmidli J, Diehm C, Biamino G, Vermassen F, Scheinert D, van Sambeek MR, Schillinger M. A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischaemia of lower limb arteries. Eur Heart J. 2007 Apr;28(7):798-805. doi: 10.1093/eurheartj/ehl545. Epub 2007 Feb 22.

Reference Type BACKGROUND
PMID: 17317699 (View on PubMed)

Other Identifiers

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114/08

Identifier Type: -

Identifier Source: org_study_id

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