Evaluation of the Safety and Efficacy of the Paclitaxel Eluting Hemodialysis Shunt Balloon Dilatation Catheter (APERTO) in Treatment of Hemodialysis Arteriovenous Fistulae Stenosis: A Prospective, Multicenter, Randomized, Controlled Clinical Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 161
- 试验地点
- 9
- 主要终点
- Primary patency rate of the target lesion
研究概览
简要总结
To evaluate the safety and efficacy of Paclitaxel Eluting Hemodialysis Shunt Balloon Dilatation Catheter (APERTO) compared with the Balloon Dilatation catheter (OHICHO II) for the treatment of Arteriovenous Fistulae Stenosis in patients undergoing hemodialysis.
详细描述
To evaluate the safety and efficacy of the Paclitaxel Eluting Hemodialysis Shunt Balloon Dilatation Catheter (APERTO) compared with the Balloon Dilatation catheter (OHICHO II) for the treatment of Arteriovenous Fistulae Stenosis in patients undergoing hemodialysis.
This is a prospective, multi-center, randomized controlled, open-label, superiority study. A total of 160 subjects will be enrolled from 10 sites in China. All subjects enrolled will be randomly assigned to the test group (APERTO group, n=80) and the control group (OHICHO II group, n=80) with randomized allocation ratio of 1:1. Subjects in the test group and the control group will be treated with APERTO OTW or OHICHO II respectively.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients must meet all of the following criteria:
- •Age ≥ 18 years and ≤ 75 years, male or female.
- •Patient or legally authorized representative can understand the purpose of this clinic trial. He or She volunteers to participate in this trial and can provide written informed consent, and is willing to accept the scheduled follow-up in specific time points.
- •Angiography, ultrasound or clinical diagnosis shows that patients have hemodialysis access dysfunction due to stenosis lesions.
- •Patients with indications of the percutaneous endovascular therapy, that is, the AVF stenosis is related to hemodynamics and ≥ 50%, and with any of the following clinical and physiological abnormalities (referred to NKF-K/DOQI guideline definitions):
- •Thrombosis in the AVF;
- •Elevated venous pressure during dialysis
- •Obvious abnormality in recirculation measurements
- •Abnormal physical examination findings
- •Unexplained decreases in dialysis dose
- •Decreased access flow
- •Target lesion is a de novo or restenosis. The number of target lesions is
- •Target lesion consists of a single lesion or a multiple lesions with target lesion length ≤ 40 mm.
- •Target lesion(s) is located in the reflux vein which is from the anastomosis of native arteriovenous fistula (AVF) to the distal end of subclavian vein, except the anastomosis of native AVF.
- •If patient has non-target lesion, it must be successfully treated using PTA before treating target lesion.
- •Reference vessel diameter of target lesion ≥ 4.0 mm and ≤ 7.0 mm by visual estimate (determined by angiography or DUS).
- •Hemodialysis access previously used (mature AVF) can no longer be successfully used due to insufficient shunt flow volume caused by local lumen stenosis.
排除标准
- •Patients will be excluded if any of the following conditions applies:
- •Patients who have participated in another investigational drug or device trial.
- •Patients who have been enrolled in this trial previously.
- •Women of childbearing age with negative pregnancy test before procedure, and breastfeeding women.
- •Any major surgical procedure (such as thoracotomy, craniotomy, etc.) within 30 days prior to the procedure.
- •Any planned major surgical procedure (such as thoracotomy, craniotomy, etc.) within 30 days of entry into this study
- •Immature AVF, which cannot be used for Dialysis or has not been used successfully due to insufficient lumen diameter to ensure successfully puncture and insufficient shunt flow volume.
- •Patients with AVG.
- •AVF has been previously implanted with stent.
- •Lesion in AVF has been previously treated with DEB.
- •Target lesion is located in the anastomosis of native AVF.
- •Known allergies or intolerance to Paclitaxel or contrast medium.
- •Life expectancy < 1 year
- •Patients with comitans systemic lupus erythematosus and ANCA associated vasculitis.
研究组 & 干预措施
APERTO OTW group
in the APERTO OTW group the subject will be treated with APERTO OTW balloon (Paclitaxel Releasing Peripheral Balloon Dilatation Catheter)
干预措施: Paclitaxel Releasing Peripheral Balloon Dilatation Catheter (Device)
OHICHO II group
in the OHICHO II group the subject will be treated with OHICHO II balloon (Balloon Dilatation Catheter)
干预措施: Balloon Dilatation Catheter (Device)
结局指标
主要结局
Primary patency rate of the target lesion
时间窗: at 6 month post procedure
Primary patency is defined as freedom from restenosis as determined by DUS Peak Systolic Velocity Ratio (PSVR) ≤ 2.0 and freedom from clinically-driven target lesion revascularization (CD-TLR). Restenosis is defined as PSVR\> 2.0 determined by independent DUS laboratory. Clinically-driven target lesion revascularization (CD-TLR) is defined as any re-intervention in target lesion (+/-5mm proximal or distal of the target lesion) determined by DUS due to clinical symptoms or dialysis indicators showing that it is unable to perform dialysis.
次要结局
- MAE rates (death or stroke)(at 1 month, 3 months, 6 months, and 12 months post procedure.)
- The diameter stenosis rate in target lesion(at 6 months post procedure)
- Clinical-driven Target Lesion Revascularization (CD-TLR)(in1st, 3rd, 6th, 12th month post operation)
- Clinical Success(at 1 month)
- Clinical-driven Target Shunt Revascularization (CD-TSR)(in 1st, 3rd, 6th, 12th month post operation)
- Device Success(intraoperative)
- Technical Success(intraoperative)
- Procedural Success(at 1 month)