search
Back to results

Post-Approval Study for the FLAIR Endovascular Stent Graft (RENOVA)

Primary Purpose

Stenosis of Vascular Prosthetic Devices, Implants and Grafts

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
FLAIR Endovascular Stent Graft
PTA
Sponsored by
C. R. Bard
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stenosis of Vascular Prosthetic Devices, Implants and Grafts focused on measuring Hemodialysis, Vascular Prosthesis, Stenosis, End-stage Renal Disease (ESRD)

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject must be either a male or non-pregnant female greater than or equal to 21 years of age
  • Subject is willing to comply with the protocol requirements and can be contacted by telephone
  • Subject has a synthetic AV access graft located in an arm that has been implanted for greater than or equal to 30 days and has undergone at least one successful dialysis session prior to the index procedure
  • Angiographic evidence (per the institution's standard) is available to indicate that the subject has a stenosis greater than or equal to 50% located at the graft-vein anastomosis of subject's synthetic AV access graft
  • The target lesion is estimated to be less than or equal to 7 cm in length (by angiography)
  • The entire target lesion is located within 7 cm of the graft-vein anastomosis, as verified by angiography, such that approximately 1 cm of the FLAIR™ Endovascular Stent Graft will extend into non-diseased vein and approximately 1 cm but no more than 2 cm of the FLAIR™ Endovascular Stent Graft will extend into the non-diseased AV graft
  • Full expansion of an appropriately sized angioplasty balloon, in the operator's judgment, can be achieved during primary angioplasty
  • Graft diameter at the deployment site is between 5 mm and 8 mm as verified by angiography

Exclusion Criteria:

  • The subject has a life expectancy of < 25 months.
  • The target lesion has had a corresponding thrombosis treated less than or equal to 7 days prior to the index procedure.
  • A previously placed stent and/or stent graft located in the treatment area is present. Treatment area includes the entire target lesion and 1 cm of landing zone into both non-diseased AV graft and non-diseased vein.
  • The subject has an infected AV access graft or uncontrolled systemic infection.
  • The presence of additional lesion(s) in the access circuit less than or equal to 3 cm from the edges of the target lesion that was treated less than or equal to 30 days prior to index procedure.
  • The presence of additional lesion(s) in the access circuit > 3 cm from the edges of the primary lesion that are greater than or equal to 30% stenosed. Note: Subjects may be included if the additional lesions(s) can be successfully treated with a final residual stenosis of < 30% prior to the index procedure.
  • The location of the target lesion would require that the FLAIR™ Endovascular Stent Graft be deployed fully across the elbow joint (radiographically identified by a combination of the humeroulnar joint and the humeroradial joint).
  • The location of the target lesion would require that the FLAIR™ Endovascular Stent Graft cross an angle (between the inflow vein and synthetic AV access graft) that is > 90 degrees.
  • The subject has an uncontrolled blood coagulation disorder.
  • The subject has a known allergy or sensitivity to contrast media which cannot be adequately pre-medicated.
  • The subject has a known hypersensitivity to nickel-titanium.
  • Subjects who are currently enrolled or who plan to enroll in other investigations that conflict with follow-up testing or confounds data in this trial.

Sites / Locations

  • Access Connections

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

FLAIR

PTA Only

Arm Description

FLAIR Endovascular Stent Graft

Percutaneous Transluminal Angioplasty

Outcomes

Primary Outcome Measures

ACPP Was Defined as the Interval Following the Index Procedure Until the Next Access Thrombosis or Reintervention.
To demonstrate that the post intervention Access Circuit Primary Patency (ACPP) of FLAIR™ is superior to that of PTA at 12 months post study procedure.
The Index of Patency Function (IPF) [the Average Number of Months Between Interventions] of FLAIR™ is Not Inferior to That of PTA at 12 Months Post Study Procedure.
The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the arteriovenous (AV) access circuit in order to maintain vascular access for hemodialysis.
The Number of Participants With Device and/or Procedure Related Adverse Events at 12 Months Post Study Procedure.

Secondary Outcome Measures

To Assess the Number of Re-interventions to the Access Circuit Until Graft Abandonment or Through 12 Months Post-index Procedure
The estimated number of re-interventions to the access circuit until graft abandonment or through 12 months post-index procedure was a secondary endpoint without hypothesis testing and is therefore summarized descriptively.
Post-Intervention Assisted Primary Patency at 12 Months
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Post-intervention Secondary Patency (PSP) at 12 Months
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.
Procedural Success
Procedural success was a secondary endpoint without hypothesis testing and is therefore summarized descriptively. Procedural success is defined as anatomic success and at least one indicator of hemodynamic or clinical success.
Analysis of Proportion of Serious Adverse Events Classified as Device and/or Procedure-Related Through 30 Days Post-Procedure
The incidence of device-related and procedure-related serious adverse events (SAEs) from the index procedure through 30 days post procedure is summarized. The purpose of this analysis was to assess the effectiveness of the Bard Peripheral Vascular (BPV) clinician training program.
Demonstrate Non-inferiority of FLAIR Safety in Terms of Serious Adverse Events at 12 Months
Serious Adverse Events at 12 months are reported for all 270 subjects.
Access Circuit Primary Patency (ACCP) at 24 Months Procedure Until the Next Access Thrombosis or Reintervention.
Access Circuit Primary Patency (ACPP) was defined as the interval following the index procedure until the next access thrombosis or reintervention at 24 months.
To Estimate Safety at 24 Months.
To estimate the percentage of participants without safety issues through 24 months.
Post-Intervention Assisted Primary Patency at 24 Months
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Post-intervention Secondary Patency at 24 Months
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.
Index of Patency Function (IPF) [the Average Number of Months Between Interventions] Rates of FLAIR™ and PTA at at 24 Months.
The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the AV access circuit in order to maintain vascular access for hemodialysis.
Post-Intervention Assisted Primary Patency at 6 Months
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Post-intervention Secondary Patency at 6 Months
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.

Full Information

First Posted
May 12, 2008
Last Updated
January 30, 2017
Sponsor
C. R. Bard
search

1. Study Identification

Unique Protocol Identification Number
NCT00677235
Brief Title
Post-Approval Study for the FLAIR Endovascular Stent Graft
Acronym
RENOVA
Official Title
A Prospective, Randomized, Concurrently-Controlled Post-Approval Study of the FLAIR Endovascular Stent Graft
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to confirm the long-term safety and effectiveness of the FLAIR Endovascular Stent Graft for treatment of stenoses at the venous anastomosis of ePTFE or other synthetic arteriovenous (AV) access grafts.
Detailed Description
The purpose of the study is to compare efficacy data on subjects randomized to treatment with percutaneous transluminal angioplasty (PTA) and the FLAIR™ Endovascular Stent Graft versus subjects randomized to treatment with PTA only.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stenosis of Vascular Prosthetic Devices, Implants and Grafts
Keywords
Hemodialysis, Vascular Prosthesis, Stenosis, End-stage Renal Disease (ESRD)

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
270 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FLAIR
Arm Type
Experimental
Arm Description
FLAIR Endovascular Stent Graft
Arm Title
PTA Only
Arm Type
Active Comparator
Arm Description
Percutaneous Transluminal Angioplasty
Intervention Type
Device
Intervention Name(s)
FLAIR Endovascular Stent Graft
Intervention Description
Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
Intervention Type
Procedure
Intervention Name(s)
PTA
Intervention Description
Treatment of stenoses with PTA only
Primary Outcome Measure Information:
Title
ACPP Was Defined as the Interval Following the Index Procedure Until the Next Access Thrombosis or Reintervention.
Description
To demonstrate that the post intervention Access Circuit Primary Patency (ACPP) of FLAIR™ is superior to that of PTA at 12 months post study procedure.
Time Frame
12 months
Title
The Index of Patency Function (IPF) [the Average Number of Months Between Interventions] of FLAIR™ is Not Inferior to That of PTA at 12 Months Post Study Procedure.
Description
The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the arteriovenous (AV) access circuit in order to maintain vascular access for hemodialysis.
Time Frame
12 months
Title
The Number of Participants With Device and/or Procedure Related Adverse Events at 12 Months Post Study Procedure.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
To Assess the Number of Re-interventions to the Access Circuit Until Graft Abandonment or Through 12 Months Post-index Procedure
Description
The estimated number of re-interventions to the access circuit until graft abandonment or through 12 months post-index procedure was a secondary endpoint without hypothesis testing and is therefore summarized descriptively.
Time Frame
Patient Follow-Up
Title
Post-Intervention Assisted Primary Patency at 12 Months
Description
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Time Frame
12 months
Title
Post-intervention Secondary Patency (PSP) at 12 Months
Description
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.
Time Frame
12 months
Title
Procedural Success
Description
Procedural success was a secondary endpoint without hypothesis testing and is therefore summarized descriptively. Procedural success is defined as anatomic success and at least one indicator of hemodynamic or clinical success.
Time Frame
Patient Follow-Up
Title
Analysis of Proportion of Serious Adverse Events Classified as Device and/or Procedure-Related Through 30 Days Post-Procedure
Description
The incidence of device-related and procedure-related serious adverse events (SAEs) from the index procedure through 30 days post procedure is summarized. The purpose of this analysis was to assess the effectiveness of the Bard Peripheral Vascular (BPV) clinician training program.
Time Frame
Patient Follow-Up
Title
Demonstrate Non-inferiority of FLAIR Safety in Terms of Serious Adverse Events at 12 Months
Description
Serious Adverse Events at 12 months are reported for all 270 subjects.
Time Frame
12 months
Title
Access Circuit Primary Patency (ACCP) at 24 Months Procedure Until the Next Access Thrombosis or Reintervention.
Description
Access Circuit Primary Patency (ACPP) was defined as the interval following the index procedure until the next access thrombosis or reintervention at 24 months.
Time Frame
24 months
Title
To Estimate Safety at 24 Months.
Description
To estimate the percentage of participants without safety issues through 24 months.
Time Frame
24 months
Title
Post-Intervention Assisted Primary Patency at 24 Months
Description
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Time Frame
24 month follow up
Title
Post-intervention Secondary Patency at 24 Months
Description
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.
Time Frame
24 months
Title
Index of Patency Function (IPF) [the Average Number of Months Between Interventions] Rates of FLAIR™ and PTA at at 24 Months.
Description
The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the AV access circuit in order to maintain vascular access for hemodialysis.
Time Frame
24 months
Title
Post-Intervention Assisted Primary Patency at 6 Months
Description
Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.
Time Frame
6 month follow up
Title
Post-intervention Secondary Patency at 6 Months
Description
Postintervention secondary patency [PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.
Time Frame
6 month follow-up

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must be either a male or non-pregnant female greater than or equal to 21 years of age Subject is willing to comply with the protocol requirements and can be contacted by telephone Subject has a synthetic AV access graft located in an arm that has been implanted for greater than or equal to 30 days and has undergone at least one successful dialysis session prior to the index procedure Angiographic evidence (per the institution's standard) is available to indicate that the subject has a stenosis greater than or equal to 50% located at the graft-vein anastomosis of subject's synthetic AV access graft The target lesion is estimated to be less than or equal to 7 cm in length (by angiography) The entire target lesion is located within 7 cm of the graft-vein anastomosis, as verified by angiography, such that approximately 1 cm of the FLAIR™ Endovascular Stent Graft will extend into non-diseased vein and approximately 1 cm but no more than 2 cm of the FLAIR™ Endovascular Stent Graft will extend into the non-diseased AV graft Full expansion of an appropriately sized angioplasty balloon, in the operator's judgment, can be achieved during primary angioplasty Graft diameter at the deployment site is between 5 mm and 8 mm as verified by angiography Exclusion Criteria: The subject has a life expectancy of < 25 months. The target lesion has had a corresponding thrombosis treated less than or equal to 7 days prior to the index procedure. A previously placed stent and/or stent graft located in the treatment area is present. Treatment area includes the entire target lesion and 1 cm of landing zone into both non-diseased AV graft and non-diseased vein. The subject has an infected AV access graft or uncontrolled systemic infection. The presence of additional lesion(s) in the access circuit less than or equal to 3 cm from the edges of the target lesion that was treated less than or equal to 30 days prior to index procedure. The presence of additional lesion(s) in the access circuit > 3 cm from the edges of the primary lesion that are greater than or equal to 30% stenosed. Note: Subjects may be included if the additional lesions(s) can be successfully treated with a final residual stenosis of < 30% prior to the index procedure. The location of the target lesion would require that the FLAIR™ Endovascular Stent Graft be deployed fully across the elbow joint (radiographically identified by a combination of the humeroulnar joint and the humeroradial joint). The location of the target lesion would require that the FLAIR™ Endovascular Stent Graft cross an angle (between the inflow vein and synthetic AV access graft) that is > 90 degrees. The subject has an uncontrolled blood coagulation disorder. The subject has a known allergy or sensitivity to contrast media which cannot be adequately pre-medicated. The subject has a known hypersensitivity to nickel-titanium. Subjects who are currently enrolled or who plan to enroll in other investigations that conflict with follow-up testing or confounds data in this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ziv Haskal, MD
Organizational Affiliation
University of Maryland Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Access Connections
City
Bamberg
State/Province
South Carolina
ZIP/Postal Code
29003
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
27388566
Citation
Haskal ZJ, Saad TF, Hoggard JG, Cooper RI, Lipkowitz GS, Gerges A, Ross JR, Pflederer TA, Mietling SW. Prospective, Randomized, Concurrently-Controlled Study of a Stent Graft versus Balloon Angioplasty for Treatment of Arteriovenous Access Graft Stenosis: 2-Year Results of the RENOVA Study. J Vasc Interv Radiol. 2016 Aug;27(8):1105-1114.e3. doi: 10.1016/j.jvir.2016.05.019. Epub 2016 Jul 4.
Results Reference
result

Learn more about this trial

Post-Approval Study for the FLAIR Endovascular Stent Graft

We'll reach out to this number within 24 hrs