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Ellipsys Vascular Access System Post Market Surveillance (PS) Study

Not Applicable
Completed
Conditions
Kidney Disease, End-Stage
AV Fistula
Renal Disease, End Stage
Fistulas Arteriovenous
Interventions
Device: Ellipsys Vascular Access System
Registration Number
NCT04484220
Lead Sponsor
Medtronic Endovascular
Brief Summary

The proposed clinical study is a prospective, non-randomized, multi-center, single-arm, observational, post-market surveillance (PS) study of the Ellipsys Vascular Access System in subjects eligible for arteriovenous (AV) fistula.

Detailed Description

The primary objective of this post-market surveillance study is to support the short-term safety of the device and procedure and further assess long-term safety and effectiveness in subjects treated by newly trained providers of the Ellipsys Vascular Access System in the creation of a native AV fistula via percutaneous access in subjects who are on hemodialysis and are medically indicated for the creation of an upper limb anastomosis.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
142
Inclusion Criteria
  1. Male or non-pregnant female ≥ 18 years of age and ≤ 80 years of age

  2. Life expectancy of at least one year, in the investigator's opinion

  3. Diagnosed with ESRD or chronic kidney disease on hemodialysis.

  4. Patients deemed medically eligible for upper extremity autogenous AV fistula creation, per institutional guidelines and/or clinical judgment

  5. Adequate quality vein based on pre-operative assessment

    1. Adjacent vein diameter of ≥2.0 mm at target anastomosis site
    2. Confirmed clinically significant outflow
  6. Adequate quality radial artery based on pre-operative assessment

    a. Arterial lumen diameter of ≥2.0 mm at target anastomosis site

  7. Adequate collateral arterial perfusion with patent palmar arch as demonstrated by Barbeau Test or Allen's Test.

  8. Radial artery-adjacent vein proximity ≤1.5 mm measured lumen edge-to-lumen edge as determined by pre-procedural ultrasound and confirmed pre-procedure

  9. Patient is able to provide written informed consent and attend follow-up examinations at the enrolling institution

    Imaging-based Inclusion Criteria:

  10. Confirm radial artery-adjacent vein proximity ≤1.5 mm measured lumen edge-to-lumen edge as determined by pre-procedural ultrasound and confirmed pre-procedurally

  11. Confirm radial artery and adjacent vein diameter of ≥2.0 mm at target anastomosis site

Exclusion Criteria
  1. Pre-existing ipsilateral vascular disease interfering with the study procedure or potentially confounding the study results including:

    1. Documented or suspected central venous stenosis (≥ 50%) or
    2. Upper extremity arterial stenosis or
    3. Vascular disease at the radial artery / adjacent vein site
  2. Prior vascular surgery at or proximal (central) to the AVF target site interfering with AVF maturation or other ipsilateral surgery that could potentially confound the study results such as prior axillary dissection or mastectomy

  3. History of steal syndrome from a previous surgical ipsilateral hemodialysis vascular access which required intervention or abandonment

  4. Systolic pressures < 100 mg Hg at the time of screening

  5. Suspected or confirmed skin disease at the skin entry site

  6. Edema of the upper extremity on the ipsilateral side

  7. Immunocompromised subjects due to underlying disease or immunosuppressant therapy such as sirolimus (Rapamune®) or Prednisone at a dose of > 10 mg per day

  8. Known bleeding diathesis, coagulation disorder or medications putting the subject at increased risk, in the Investigator's judgment

  9. Patients with acute or active infection

  10. Scheduled kidney transplant within 6 months of enrollment

  11. Participation in another clinical investigation (excluding retrospective studies or studies not requiring a consent form)

  12. History of substance abuse or anticipated to be non-compliant with medical care or study requirements based on investigator judgment

  13. Patient has an active COVID-19 infection with ongoing sequela or hospitalization for treatment of COVID-19.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Ellipsys Vascular Access SystemEllipsys Vascular Access SystemThe Ellipsys System is indicated for the creation of a proximal radial artery to perforating vein anastomosis via a retrograde venous access approach in patients who have chronic kidney disease requiring dialysis.
Primary Outcome Measures
NameTimeMethod
Early Occlusion Rate at 7 days7 days post-procedure

Percent of patients with total occlusion within 7 days of the AVF creation procedure

Cumulative Patency Through 12 months Post-AVF Creation12 months post-procedure

Freedom from access abandonment from time of access creation

Study Related Serious Adverse Event (SAE) Rate Through 12 months12 months post-procedure

Rate of serious adverse events through 12 months related to the device, study procedure, or secondary procedure to maintain or re-establish patency.

Secondary Outcome Measures
NameTimeMethod
Secondary Procedures Rate12 months post-procedure

Number of surgical or percutaneous interventions designed to mature or maintain the AVF or re-establish flow per person-year.

Assisted Primary Patency Through 12 months Post-AVF Creation12 months post-procedure

Freedom from access thrombosis from time of access creation

Overall Patient Safety12 months post-procedure

A full characterization of adverse events during the study

Primary Patency Through 12 months Post-AVF Creation12 months post-procedure

Freedom from access thrombosis or any intervention designed to facilitate, maintain or re-establish patency measured from time of access creation through 12 months

Trial Locations

Locations (12)

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

University of Pittsburg Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Nephrology Associates Access Center

🇺🇸

Riverside, California, United States

Coastal Vascular and Interventional, PLLC

🇺🇸

Pensacola, Florida, United States

Azura Vascular Care, Jacksonville

🇺🇸

Jacksonville, Florida, United States

The Vascular Care Group

🇺🇸

Hyannis, Massachusetts, United States

Staten Island Hospital

🇺🇸

Staten Island, New York, United States

Nephrology Kidney Disease Hypertension Center

🇺🇸

Las Vegas, Nevada, United States

STAR Vascular Access Center

🇺🇸

San Antonio, Texas, United States

San Antonio Kidney Disease Center

🇺🇸

San Antonio, Texas, United States

Richmond Vascular Center

🇺🇸

North Chesterfield, Virginia, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

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