Clinical Study of the BARD® COVERA™ Arteriovenous (AV) Stent Graft

NCT ID: NCT02649946

Last Updated: 2021-12-21

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2021-02-28

Brief Summary

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The objective of this study is to assess the safety and effectiveness of the COVERA™ Vascular Covered Stent for the treatment of stenotic lesions in the upper extremity venous outflow of the Arteriovenous (AV) access circuit.

Detailed Description

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This study will compare the use of the COVERA™ Vascular Covered Stent (following percutaneous transluminal angioplasty (PTA)) to PTA alone for the treatment of stenotic lesions in the upper extremity venous outflow of the arteriovenous (AV) access circuit of subjects dialyzing with an AV fistula.

Conditions

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Stenosis Restenosis

Keywords

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ESRD Stenosis Restenosis Hemodialysis AV Fistula Arteriovenous (AV)

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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Covera Vascular Covered Stent following PTA

Placement of the Covera Vascular Covered Stent following percutaneous transluminal angioplasty (PTA)

Group Type EXPERIMENTAL

Covera Vascular Covered Stent following PTA

Intervention Type DEVICE

Treatment of stenoses with primary percutaneous transluminal angioplasty (PTA) and placement of the Covera Vascular Covered Stent.

PTA only using uncoated PTA Balloon

Percutaneous Transluminal Angioplasty (PTA) will be performed using a commercially available uncoated PTA balloon. Balloons with an external wire support, cutting/scoring component or other similar modifications are not permitted. Multiple balloons, inflations and/or prolonged inflation may be used.

Group Type ACTIVE_COMPARATOR

Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon

Intervention Type PROCEDURE

Treatment of stenoses with PTA only

Interventions

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Covera Vascular Covered Stent following PTA

Treatment of stenoses with primary percutaneous transluminal angioplasty (PTA) and placement of the Covera Vascular Covered Stent.

Intervention Type DEVICE

Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon

Treatment of stenoses with PTA only

Intervention Type PROCEDURE

Other Intervention Names

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Standard Balloon Angioplasty (POBA)

Eligibility Criteria

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Inclusion Criteria

* Subject must voluntarily sign and date the Informed Consent Form (ICF) prior to collection of study data or performance of study procedures.
* Subject must be either a male or non-pregnant female ≥ 21 years of age with an expected lifespan sufficient to allow for completion of all study procedures.
* Subject must be willing to comply with the protocol requirements, including the clinical and telephone follow-up.
* Subject must have an upper extremity arteriovenous (AV) fistula that has undergone at least one successful dialysis session with two-needle cannulation, prior to the index procedure.


* Subject must have angiographic evidence of a stenosis ≥ 50% (by visual estimation) located in the venous outflow of the AV access circuit and present with clinical or hemodynamic evidence of AV fistula dysfunction.
* The target lesion must be ≤ 9cm in length. Note: multiple stenoses may exist within the target lesion.
* The reference vessel diameter of the adjacent non-stenotic vein must be between 5.0 and 9.0mm.

Exclusion Criteria

* The subject is dialyzing with an AV graft.
* The target lesion has had a corresponding thrombosis treated within 7 days prior to the index procedure.
* The hemodialysis access is located in the lower extremity.
* The subject has an infected AV fistula or uncontrolled systemic infection.
* The subject has a known uncontrolled blood coagulation/bleeding disorder.
* The subject has a known allergy or hypersensitivity to contrast media which cannot be adequately pre-medicated.
* The subject has a known hypersensitivity to nickel-titanium (Nitinol) or tantalum.
* The subject has another medical condition, which, in the opinion of the Investigator, may cause him/her to be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow for the completion of study procedures and follow-up.
* The subject is currently participating in an investigational drug or another device study that has not completed the study treatment or that clinically interferes with the study endpoints. Note: Studies requiring extended follow-up visits for products that were investigational, but have since become commercially available, are not considered investigational studies.


* Additional stenotic lesions (≥ 50%) in the venous outflow that are \> 3cm from the edge of the target lesion and are not successfully treated (defined as \< 30% residual stenosis) prior to treating the target lesion.
* An aneurysm or pseudoaneurysm is present within the target lesion.
* The location of the target lesion would require the COVERA™ Vascular Covered Stent be deployed across the elbow joint.
* The target lesion is located within a stent.
* The location of the target lesion would require that the COVERA™ Vascular Covered Stent be deployed at or across the segment of fistula utilized for dialysis needle puncture (i.e., "cannulation zone").
* The location of the target lesion would require that the COVERA™ Vascular Covered Stent be placed in the central veins (subclavian, brachiocephalic, superior vena cava (SVC)) or under the clavicle at the thoracic outlet.
* There is incomplete expansion of an appropriately sized angioplasty balloon to its expected profile, in the operator's judgment, during primary angioplasty at the target lesion prior to randomization.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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C. R. Bard

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bart Dolmatch, M.D.

Role: PRINCIPAL_INVESTIGATOR

The Palo Alto Medical Foundation

Locations

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Southwest Vascular Center

Tempe, Arizona, United States

Site Status

Alliance Research Centers

Laguna Hills, California, United States

Site Status

Radiology Imaging Associates

Englewood, Colorado, United States

Site Status

Yale University & Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status

Nephrology Associates, P.A.

Newark, Delaware, United States

Site Status

Jacksonville Center for Clinical Research

Jacksonville, Florida, United States

Site Status

First Coast Cardiovascular Institute

Jacksonville, Florida, United States

Site Status

Ocala Kidney Group

Ocala, Florida, United States

Site Status

Chicago Access Care

Chicago, Illinois, United States

Site Status

Indiana University Hospital

Indianapolis, Indiana, United States

Site Status

Renal and Transplant Associates of New England, P.C.

West Springfield, Massachusetts, United States

Site Status

NC Heart and Vascular Research

Raleigh, North Carolina, United States

Site Status

NC Nephrology

Raleigh, North Carolina, United States

Site Status

Providence Access Care

Providence, Rhode Island, United States

Site Status

Tarrant Vascular Clinic

Fort Worth, Texas, United States

Site Status

Clinical Advancement Center, PLLC

San Antonio, Texas, United States

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Royal Adelaide Hospital

Kensington Gardens, South Australia, Australia

Site Status

LKH-Univ. Klinikum Graz

Graz, , Austria

Site Status

University Hospital Leuven

Leuven, Vlaams-Brabant, Belgium

Site Status

Universitätsklinikum Würzburg

Würzburg, , Germany

Site Status

Maastricht Universitair Medish Centrum

Maastricht, , Netherlands

Site Status

Middlemore Hospital

Auckland, , New Zealand

Site Status

Universitaets Spital Zurich

Zurich, , Switzerland

Site Status

Countries

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United States Australia Austria Belgium Germany Netherlands New Zealand Switzerland

References

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Dolmatch B, Cabrera T, Pergola P, Balamuthusamy S, Makris A, Cooper R, Moore E, Licht J, Macaulay E, Maleux G, Pfammatter T, Settlage R, Cristea E, Lansky A; AVeNEW Trial Investigators. Prospective, randomized, multicenter clinical study comparing a self-expanding covered stent to percutaneous transluminal angioplasty for treatment of upper extremity hemodialysis arteriovenous fistula stenosis. Kidney Int. 2023 Jul;104(1):189-200. doi: 10.1016/j.kint.2023.03.015. Epub 2023 Mar 27.

Reference Type DERIVED
PMID: 36990214 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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BPV-14-005

Identifier Type: -

Identifier Source: org_study_id