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Study Comparing Synthetic Vascular Grafts in Patients With Peripheral Artery Disease (PAD) Who Require Artery Bypass.

Not Applicable
Completed
Conditions
Peripheral Arterial Occlusive Disease
Interventions
Device: vascular grafts
Registration Number
NCT01113892
Lead Sponsor
Maquet Cardiovascular
Brief Summary

To demonstrate the patency and safety of vascular grafts: EXXCEL and FUSION Bioline.

Detailed Description

The study is a prospective, randomized, single-blind, two-arm, parallel group, multi-center study to evaluate the safety and efficacy of FUSION™ Vascular Graft with Bioline (heparin) coating, compared with EXXCEL Soft ePTFE in a peripheral bypass setting, to support a claim of substantial equivalence.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
207
Inclusion Criteria
  • Patient required either above-knee or below-knee femoral popliteal bypass;
  • Patient had Category 1, 2, 3 4 or 5 chronic limb ischemia as defined by the Rutherford Categories - chronic limb ischemia severity classification scale.
  • Patient was at least 21 years of age;
  • Patient had postoperative life expectancy of >18 months;
  • Patient was willing and able to have follow-up visits and examinations;
  • Patient would not participate in other clinical trials that would conflict with this protocol
  • Patient was willing and able to provide written, informed consent.
Exclusion Criteria
  • Patient had a previous history of bypass in the diseased extremity (below the iliacs arteries);
  • Patient had percutaneous transluminal angioplasty or stenting of the target femoral or popliteal artery at the anticipated site of the proximal or distal anastomosis within the previous 30 days;
  • Patient had active infection in the region of graft placement;
  • Patient had an acute arterial occlusion requiring an emergent intervention;
  • Patient needed a cardiac surgical procedure or a different vascular surgical procedure within 30 days of planned lower extremity revascularization. Planned endovascular procedures to address proximal stenotic lesions at the time of the index femoropopliteal bypass did not exclude a patient from the study;
  • Patient required sequential extremity revascularizations or other procedures that require use of additional vascular grafts;
  • Patient had known hypersensitivity or contraindication to aspirin;
  • Patient had known coagulation disorders including hypercoagulability;
  • Patient had previous instance of heparin-induced thrombocytopenia type 2 or has known hypersensitivity to heparin; Patient was currently treated with Coumadin (warfarin) that had not been stopped within 72 hours of the planned procedure
  • Patient had severe chronic renal insufficiency (plasma/serum creatinine > 2.5 mg/dl), is undergoing hemodialysis.
  • Patient had prior renal transplant;
  • Patient had a stroke or myocardial infarction within 6 weeks of the procedure or had evidence of prior massive stroke (Modified Rankin Scale 3 or above);
  • Patient had a myocardial infarction within 6 weeks prior to the procedure or had unstable angina pectoris;
  • Patient had documented acute or suspected systemic infection;
  • Patient was a woman of reproductive potential.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EXXCEL Softvascular graftsA vascular graft comprised of extruded, expanded polytetrafluroethylene (ePTFE), indicated for use as a vascular prosthesis for replacement or bypass of diseased peripheral arteries (510(k) K962433).
FUSION Biolinevascular graftsA synthetic vascular graft constructed of two layers. The inner layer is comprised of extruded, ePTFE. The outer layer is comprised of knit polyester textile. These two layers are fused together with a proprietary polycarbonate-urethane adhesive. The vascular graft also has a heparin coating on the graft's luminal surface. The Bioline coating is a bioactive surface coating consisting of a covalent Heparin Sodium coupled to immobilized recombinant human albumin.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Primary Patency6 months

A graft was considered to have primary patency if it had remained continuously patent (i.e., had continued blood flow through it) from the time of implantation and it had uninterrupted patency with no procedure performed on it, nor a procedure to address disease progression in the adjacent native vessel. Stenosis developing within the graft without remediation or occlusion was not considered a loss of primary patency. Assessed by duplex ultrasound imaging and ankle brachial index (ABI).

The Number of Participants Meeting Composite Endpoint of Major Adverse Limb Events (MALE) and Periprocedural Death (POD)6 months

The composite endpoint included any of the following:

* Major amputation - amputation that resulted in limb shortening (e.g., proximal to, but not including transmetatarsal amputations);

* Major graft reintervention - placement of a new bypass graft at the same anatomic site, a jump/interposition graft, graft thrombectomy, graft excision, or graft thrombolysis;

* Procedure-related death - any death within 30 days of the index procedure or within 30 days of any remedial procedure performed at the same anatomic site or as a result of the index procedure.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Primary Assisted Patency6 months

Primary assisted patency was defined as continued patency without thrombosis, with or without an endovascular or open surgical intervention to remediate a stenosis or other disorder of the graft.

Time to Hemostasis of Suture Hole Bleeding (Min)Post-procedure

Time from the release of clamps until hemostasis, where hemostasis is defined as the absence of detectable bleeding from any of the suture holes.

Number of Participants With Secondary Patency6 months

Secondary patency was defined as patency after some form of intervention to restore and maintain blood flow after occlusion.

Trial Locations

Locations (25)

Montefiore Weiler Hospital

🇺🇸

Bronx, New York, United States

IKEM Praha

🇨🇿

Prague, Czechia

Central Texas Veterans Health System

🇺🇸

Temple, Texas, United States

NYU School of Medicine

🇺🇸

New York, New York, United States

Nemocnice Na Homolce

🇨🇿

Prague, Czechia

Fakulti Nemocnice Brno

🇨🇿

Brno, Czechia

Scott & White

🇺🇸

Temple, Texas, United States

Norfolk Sentara - Norfolk General Hospital

🇺🇸

Norfolk, Virginia, United States

Fakultni Nemocnice u sv Anny v Brno

🇨🇿

Brno, Czechia

Vseobecna Fakultni Nemocnice (VFN) Praha

🇨🇿

Prague, Czechia

Klinikum Karlsruhe

🇩🇪

Karlsruhe, Germany

NY Presbyterian Hospital - Columbia Univ Medical Center

🇺🇸

New York, New York, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Dallas VA Medical Center

🇺🇸

Dallas, Texas, United States

Albany Medical Center

🇺🇸

Albany, New York, United States

Central Arkansas Veterans Health System

🇺🇸

Little Rock, Arkansas, United States

VA Palo Alto HCS

🇺🇸

Palo Alto, California, United States

University Hospital Plzen

🇨🇿

Plzen, Czechia

University of Alabama-Birmingham Medical Center

🇺🇸

Birmingham, Alabama, United States

University of South Florida - Tampa General

🇺🇸

Tampa, Florida, United States

Methodist Hospital

🇺🇸

Houston, Texas, United States

Brigham and Women's Hospital

🇺🇸

Boston, Massachusetts, United States

Swedish Medical Center

🇺🇸

Seattle, Washington, United States

Dartmouth- Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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