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Trial Comparing Angiography and Angiography With IVUS for Treatment of Hemodialysis Access Failures

Phase 4
Conditions
Dialysis Access Malfunction
Interventions
Device: Angiography with IVUS
Registration Number
NCT02056704
Lead Sponsor
Baylor Research Institute
Brief Summary

The reason the investigators are doing this study is to compare the results of angiography versus angiography with intravascular ultrasound in dialysis grafts/fistulas that are blocked.

Detailed Description

Patients with kidney failure have a fistula or graft for long-term dialysis in order for the dialysis machine to draw blood, filter it, and give it back to the patient. Over time, the fistula or graft may not work well enough to use for dialysis, most commonly because the veins may develop "scar tissue" within and around them that narrows the vein resulting in poor flow or complete blockage.

These blockages are commonly opened with wires, balloons (a procedure called angioplasty), and stents. These blockages are seen with angiography, a special type of x-ray used with a dye that shows the inside of the blood vessels. Intravascular ultrasound (IVUS) is a type of imaging that uses sound waves to produce an image of the inside of blood vessels and to see their condition. Currently, it is not known if angiography alone or angiography with IVUS has better results. The reason we are doing this study is to compare the results of angiography versus angiography with IVUS.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • > 18 years old
  • Male or female (non-pregnant females)
  • Patients with hemodialysis access failure (arteriovenous fistulae or arteriovenous grafts)
  • Patients must undergo elective angiographies (fistulograms) based on surveillance duplex ultrasound findings (stenosis)
  • Patients with outflow stenoses between 1 cm distal to an arterial anastamosis and clavicle in AV fistulae or between venous anastamosis and clavicle in AV grafts found on surveillance duplex ultrasound
Exclusion Criteria
  • Patients with other etiologies (inflow lesions, intragraft lesions, hypercoagulable states, lesions not readily amenable to stenting), advanced failures (thrombosis, central venous occlusion), and non-routine access conformations (chest wall/groin grafts, balloon assisted maturation)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Angiography with IVUSAngiography with IVUSEvaluation with angiography and intravascular ultrasound.
Primary Outcome Measures
NameTimeMethod
Change in characteristics of lesion within the vesselevery 3 months - up to 2 years

This will include vessel diameters proximal and distal to lesions, percent stenosis, and lesion lengths.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (4)

Baylor Jack and Jane Hamilton Heart and Vascular Hospital

🇺🇸

Dallas, Texas, United States

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

The Heart Hospital Baylor Plano

🇺🇸

Plano, Texas, United States

Baylor Regional Medical Center at Plano

🇺🇸

Plano, Texas, United States

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