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Restenosis Following Paclitaxel Eluting Balloon Angioplasty of Hemodialysis Access Stenosis

Phase 2
Completed
Conditions
Renal Failure
Interventions
Device: Percutaneous Transluminal Angioplasty (PTA)
Device: Paclitaxel Eluting Balloon Angioplasty
Registration Number
NCT01001676
Lead Sponsor
University Health Network, Toronto
Brief Summary

Introduction: Narrowing of the draining vein occurs in \>50% of hemodialysis fistula and left untreated will lead to loss of access. The narrowing is due to excessive growth of tissue in the vessel wall (intimal hyperplasia). The standard treatment is balloon dilatation. However, narrowing will inevitably recur in 2-3 months hence requiring further dilatation. Intimal hyperplasia also occurs in the heart and leg circulation. The drug paclitaxel has been used with great success in preventing intimal hyperplasia in these vessels following balloon dilatation. Administer locally, paclitaxel inhibits excess tissue growth in the vessel wall. The investigators believe that this drug will have similar effect in hemodialysis access..

Objective: To assess the effect of paclitaxel in hemodialysis access with narrowing. Paclitaxel is delivered by a paclitaxel-coated balloon. This balloon dilates the narrow segment and simultaneously delivers paclitaxel to the vessel wall.

Methodology: Patients with narrowed hemodialysis access are dilated with the paclitaxel-coated balloon or conventional balloon in randomized manner. The patency of the two groups are evaluated and compared at 6 months follow-up.

Potential benefit: Decrease number of balloon dilatations and hence hospital admissions, improve dialysis fistula function, and decrease overall economic cost.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Hemodialysis access located in the forearm or upper arm
  • Patient with clinical or hemodynamic evidence of graft dysfunction
  • Hemodialysis access is > 3 months old
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Exclusion Criteria
  • Intervention of the vascular access circuit within the past 30 days
  • Thrombosed/clotted access
  • Evidence of systemic infection or a local infection associated with the graft
  • Positive pregnancy test within 7 days before enrolment
  • Patient is scheduled for a kidney transplant
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional Balloon AngioplastyPercutaneous Transluminal Angioplasty (PTA)-
Drug Eluting Balloon AngioplastyPaclitaxel Eluting Balloon Angioplasty-
Primary Outcome Measures
NameTimeMethod
Primary patencyat 6 months
Secondary Outcome Measures
NameTimeMethod
Transonic blood flowsmonthly for up to 6 months

Trial Locations

Locations (1)

University Health Network

🇨🇦

Toronto, Ontario, Canada

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