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Post Approval Study Investigating Lutonix Drug Coated Balloon for Treatment of Dysfunctional Arteriovenous Fistulae (AVPAS)

Primary Purpose

Arteriovenous Fistula

Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
LUTONIX 035 Drug Coated Balloon PTA Catheter
Sponsored by
C. R. Bard
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arteriovenous Fistula

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or non-pregnant, non-breastfeeding female ≥18 years of age
  2. Subject is willing to provide informed consent, and is willing to comply with the protocol-required follow up visits
  3. Target lesion must be a mature arteriovenous fistula located in the arm presenting with any clinical, physiological or hemodynamic abnormalities warranting angiographic imaging as defined in the K/DOQI guidelines
  4. Subject has a target lesion that can be treated with available LUTONIX DCB according to the Instructions For Use (IFU)
  5. Venous stenosis of an AV fistula in which the target lesion is located from the anastomosis to the axillosubclavian junction, as defined by insertion of the cephalic vein
  6. Successful pre-dilation of the target lesion with an uncoated percutaneous transluminal angioplasty (PTA) balloon defined as:

    1. No clinically significant dissection;
    2. No extravasation requiring treatment;
    3. Residual stenosis ≤30% by angiographic measurement;
    4. Ability to completely efface the waist using the pre-dilation balloon.

Exclusion Criteria:

  1. Subject is currently participating in an investigational drug, biologic, or device study, or previous enrollment in this study
  2. Subject has a non-controllable allergy to contrast
  3. Subject has another medical condition that, in the opinion of the Investigator, may confound the data interpretation or is associated with a life expectancy insufficient to allow for completion of subject study procedure and follow up
  4. Target lesion is located central to the axillosubclavian junction
  5. A thrombosed access or an access with a thrombosis treated ≤7 days before to the index procedure
  6. Prior surgical interventions of the access site ≤30 days before the index procedure
  7. Target lesion is located within a bare metal or covered stent

Sites / Locations

  • University of Alabama at Birmingham
  • Flowers Hospital
  • St. Joseph Hospital of Orange
  • Kaiser PermanenteRecruiting
  • Yale University
  • University of Iowa Hospital and ClinicsRecruiting
  • University of LouisvilleRecruiting
  • Ochsner Health SystemRecruiting
  • Ochsner Louisiana State University HealthRecruiting
  • MedStar Health Research Institute
  • Beth Israel Deaconess Medical CenterRecruiting
  • University of MichiganRecruiting
  • University of MinnesotaRecruiting
  • Hackensack University Medical Center
  • Columbia University Medical CenterRecruiting
  • Rochester General Hospital
  • Penn State Health Milton S. Hershey Medical CenterRecruiting
  • Dallas Vascular CenterRecruiting
  • HCA Houston HealthcareRecruiting
  • Houston Methodist HospitalRecruiting
  • University of Texas Health Science CenterRecruiting
  • Sentara Medical GroupRecruiting
  • William Osler Health System/Brampton Civic Hospital
  • Scarborough Health NetworkRecruiting
  • University Health NetworkRecruiting
  • Centre hospitalier de l'Université de MontrealRecruiting

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

LUTONIX 035 Drug Coated Balloon PTA Catheter

Arm Description

This is a single-arm study. All subjects will receive the Lutonix® 035 Drug Coated Balloon PTA Catheter.

Outcomes

Primary Outcome Measures

Percentage of Participants With Target Lesion Primary Patency (TLPP)
TLPP is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis.
Percentage of Participants With No Primary Safety Events
Primary safety events include any serious adverse event(s) involving the AV access circuit through 30 days

Secondary Outcome Measures

Percentage of Participants With Target Lesion Primary Patency
TLPP is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis.
Number of re-interventions required to maintain target lesion patency
Clinically driven reintervention is defined as a lesion that has ≥ 50% stenosis and at least one clinical, physiological or hemodynamic abnormality attributable to the stenosis defined in the K/DOQI guidelines.
Percentage of Participants With Access Circuit Primary Patency (ACPP)
Access circuit is defined as the area from the AV access anastomosis to the superior vena cava-right atrial junction.
Number of re-interventions required to maintain access circuit patency
Clinically driven reintervention is defined as a lesion that has ≥ 50% stenosis and at least one clinical, physiological or hemodynamic abnormality attributable to the stenosis defined in the K/DOQI guidelines.
Percentage of Participants With Device, Procedural, and Clinical Success
Device Success: Successful delivery to the target lesion, deployment, and retrieval at index procedure. Procedural Success: At least one indicator of hemodynamic success (e.g., physical examination with restoration of a thrill, direct measurement of flow) in the absence of peri-procedural (index procedure and through hospital stay) Serious Adverse Device Effects (SADEs). Clinical Success: The resumption of dialysis for at least one session after the index procedure.
Percentage of Participants With Abandonment of Permanent Access in the Index Extremity
The arteriovenous fistula / access circuit is considered abandoned when it is no longer being used for dialysis because the access was not functioning.
Percentage of Participants With Secondary Patency of the Access Circuit
Survival of patency of access circuit from the time of intervention until access abandonment or achievement of a censored event (death, transfer to another hemodialysis unit, transfer to peritoneal dialysis, transplantation, and end of study period), and includes all surgical and endovascular interventions.
Time to loss of target lesion secondary patency following DCB intervention
Time between first reintervention with the DCB to the next loss of patency
Percentage of Participants With Freedom from any Serious Adverse Event(s) Involving the AV Access Circuit
Safety events include any serious adverse event(s) involving the AV access circuit
Percentage of Participants With Device and Procedure Related Adverse Events
Freedom from device-related or procedure-related serious adverse events

Full Information

First Posted
April 14, 2018
Last Updated
May 16, 2023
Sponsor
C. R. Bard
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1. Study Identification

Unique Protocol Identification Number
NCT03506308
Brief Title
Post Approval Study Investigating Lutonix Drug Coated Balloon for Treatment of Dysfunctional Arteriovenous Fistulae
Acronym
AVPAS
Official Title
A Prospective, Global, Multicenter, Single Arm Post-Approval Study Investigating the Clinical Use and Safety of the Lutonix® Drug Coated Balloon PTA Catheter for the Treatment of Dysfunctional AV Fistulae
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 7, 2018 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
June 2027 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This prospective, global, multicenter, single arm post-approval study is designed to investigate the clinical use and safety of the Lutonix® 035 AV Drug Coated Balloon (DCB) PTA Catheter in subjects presenting with clinical and hemodynamic abnormalities in native arteriovenous (AV) fistulae located in the upper extremity.
Detailed Description
This post-market approval study (PAS) is required by the FDA as a condition of approval for the Lutonix drug coated balloon catheter. It is intended to demonstrate safety and assess the clinical use and outcomes of the LUTONIX Catheter in dysfunctional arteriovenous fistulae (AVF) in a heterogeneous patient population in real world clinical practice.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arteriovenous Fistula

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
213 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
LUTONIX 035 Drug Coated Balloon PTA Catheter
Arm Type
Other
Arm Description
This is a single-arm study. All subjects will receive the Lutonix® 035 Drug Coated Balloon PTA Catheter.
Intervention Type
Device
Intervention Name(s)
LUTONIX 035 Drug Coated Balloon PTA Catheter
Intervention Description
All subjects will receive the Lutonix® 035 Drug Coated Balloon PTA Catheter.
Primary Outcome Measure Information:
Title
Percentage of Participants With Target Lesion Primary Patency (TLPP)
Description
TLPP is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis.
Time Frame
6 Months
Title
Percentage of Participants With No Primary Safety Events
Description
Primary safety events include any serious adverse event(s) involving the AV access circuit through 30 days
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Percentage of Participants With Target Lesion Primary Patency
Description
TLPP is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis.
Time Frame
12, 18, 24 Months
Title
Number of re-interventions required to maintain target lesion patency
Description
Clinically driven reintervention is defined as a lesion that has ≥ 50% stenosis and at least one clinical, physiological or hemodynamic abnormality attributable to the stenosis defined in the K/DOQI guidelines.
Time Frame
6, 12, 18, 24 Months
Title
Percentage of Participants With Access Circuit Primary Patency (ACPP)
Description
Access circuit is defined as the area from the AV access anastomosis to the superior vena cava-right atrial junction.
Time Frame
6, 12, 18, 24 Months
Title
Number of re-interventions required to maintain access circuit patency
Description
Clinically driven reintervention is defined as a lesion that has ≥ 50% stenosis and at least one clinical, physiological or hemodynamic abnormality attributable to the stenosis defined in the K/DOQI guidelines.
Time Frame
6, 12, 18, 24 Months
Title
Percentage of Participants With Device, Procedural, and Clinical Success
Description
Device Success: Successful delivery to the target lesion, deployment, and retrieval at index procedure. Procedural Success: At least one indicator of hemodynamic success (e.g., physical examination with restoration of a thrill, direct measurement of flow) in the absence of peri-procedural (index procedure and through hospital stay) Serious Adverse Device Effects (SADEs). Clinical Success: The resumption of dialysis for at least one session after the index procedure.
Time Frame
24 Months
Title
Percentage of Participants With Abandonment of Permanent Access in the Index Extremity
Description
The arteriovenous fistula / access circuit is considered abandoned when it is no longer being used for dialysis because the access was not functioning.
Time Frame
6, 12, 18, 24 Months
Title
Percentage of Participants With Secondary Patency of the Access Circuit
Description
Survival of patency of access circuit from the time of intervention until access abandonment or achievement of a censored event (death, transfer to another hemodialysis unit, transfer to peritoneal dialysis, transplantation, and end of study period), and includes all surgical and endovascular interventions.
Time Frame
6, 12, 18, 24 Months
Title
Time to loss of target lesion secondary patency following DCB intervention
Description
Time between first reintervention with the DCB to the next loss of patency
Time Frame
24 Months
Title
Percentage of Participants With Freedom from any Serious Adverse Event(s) Involving the AV Access Circuit
Description
Safety events include any serious adverse event(s) involving the AV access circuit
Time Frame
6, 12, 18, 24 Months
Title
Percentage of Participants With Device and Procedure Related Adverse Events
Description
Freedom from device-related or procedure-related serious adverse events
Time Frame
6, 12, 18, 24 Months
Other Pre-specified Outcome Measures:
Title
Vital status of participants
Description
All cause death
Time Frame
36, 48, and 60 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant, non-breastfeeding female ≥18 years of age Subject is willing to provide informed consent, and is willing to comply with the protocol-required follow up visits Target lesion must be a mature arteriovenous fistula located in the arm presenting with any clinical, physiological or hemodynamic abnormalities warranting angiographic imaging as defined in the K/DOQI guidelines Subject has a target lesion that can be treated with available LUTONIX DCB according to the Instructions For Use (IFU) Venous stenosis of an AV fistula in which the target lesion is located from the anastomosis to the axillosubclavian junction, as defined by insertion of the cephalic vein Successful pre-dilation of the target lesion with an uncoated percutaneous transluminal angioplasty (PTA) balloon defined as: No clinically significant dissection; No extravasation requiring treatment; Residual stenosis ≤30% by angiographic measurement; Ability to completely efface the waist using the pre-dilation balloon. Exclusion Criteria: Subject is currently participating in an investigational drug, biologic, or device study, or previous enrollment in this study Subject has a non-controllable allergy to contrast Subject has another medical condition that, in the opinion of the Investigator, may confound the data interpretation or is associated with a life expectancy insufficient to allow for completion of subject study procedure and follow up Target lesion is located central to the axillosubclavian junction A thrombosed access or an access with a thrombosis treated ≤7 days before to the index procedure Prior surgical interventions of the access site ≤30 days before the index procedure Target lesion is located within a bare metal or covered stent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kirti Sawant
Phone
737-414-3363
Email
kirti.sawant@bd.com
First Name & Middle Initial & Last Name or Official Title & Degree
Anna Lovas
Phone
(763) 445-2385
Email
anna.lovas@bd.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Trerotola, MD
Organizational Affiliation
Hospital of the University of Pennsylvania; Division of Interventional Radiology
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dheeraj Rajan, MD
Organizational Affiliation
University Health Network; Division of Vascular & Interventional Radiology
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Individual Site Status
Terminated
Facility Name
Flowers Hospital
City
Dothan
State/Province
Alabama
ZIP/Postal Code
36305
Country
United States
Individual Site Status
Terminated
Facility Name
St. Joseph Hospital of Orange
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Individual Site Status
Terminated
Facility Name
Kaiser Permanente
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Individual Site Status
Recruiting
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Individual Site Status
Terminated
Facility Name
University of Iowa Hospital and Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Individual Site Status
Recruiting
Facility Name
Ochsner Health System
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70121
Country
United States
Individual Site Status
Recruiting
Facility Name
Ochsner Louisiana State University Health
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71103
Country
United States
Individual Site Status
Recruiting
Facility Name
MedStar Health Research Institute
City
Annapolis
State/Province
Maryland
ZIP/Postal Code
21401
Country
United States
Individual Site Status
Terminated
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Individual Site Status
Recruiting
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Individual Site Status
Terminated
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Recruiting
Facility Name
Rochester General Hospital
City
Rochester
State/Province
New York
ZIP/Postal Code
14621
Country
United States
Individual Site Status
Terminated
Facility Name
Penn State Health Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Individual Site Status
Recruiting
Facility Name
Dallas Vascular Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75208
Country
United States
Individual Site Status
Recruiting
Facility Name
HCA Houston Healthcare
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
Individual Site Status
Recruiting
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Texas Health Science Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
Sentara Medical Group
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Individual Site Status
Recruiting
Facility Name
William Osler Health System/Brampton Civic Hospital
City
Brampton
State/Province
Ontario
ZIP/Postal Code
L6R 3J7
Country
Canada
Individual Site Status
Terminated
Facility Name
Scarborough Health Network
City
Scarborough
State/Province
Ontario
ZIP/Postal Code
M1P 2V5
Country
Canada
Individual Site Status
Recruiting
Facility Name
University Health Network
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1Z5
Country
Canada
Individual Site Status
Recruiting
Facility Name
Centre hospitalier de l'Université de Montreal
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2X 0C1
Country
Canada
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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Post Approval Study Investigating Lutonix Drug Coated Balloon for Treatment of Dysfunctional Arteriovenous Fistulae

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