First-in-Human (FIH) Study of the Xeltis Hemodialysis Access Graft (aXess-FIH)
Primary Purpose
End Stage Renal Disease, End Stage Renal Failure on Dialysis
Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
aXess
Sponsored by
About this trial
This is an interventional treatment trial for End Stage Renal Disease
Eligibility Criteria
Inclusion Criteria:
- Subjects older than 18 years with end-stage renal disease (ESRD) who are not, or who are no longer, candidates for creation of an autogenous AV fistula, and therefore require placement of an AV graft in the upper extremity to start or maintain hemodialysis therapy
- Suitable anatomy for the implantation of an aXess graft
- The patient has been informed about the nature of the study, agrees to its provisions, and has provided written informed consent
- The patient has been informed and agrees to pre- and post- procedure follow up
- Life expectancy of at least 12 months
Exclusion Criteria:
- History or evidence of severe cardiac disease (NHYA Functional Class IV and/or EF <30%), myocardial infarction within six months of study entry, ventricular tachyarrhythmias requiring continuing treatment, or unstable angina
- Stroke within six months before study entry
- Active clinically significant autoimmune / inflammatory disease, immunodeficiency (including AIDS / HIV), use of immunosuppressive therapy or medication that likely interferes with restorative therapies
- Abnormal blood values (e.g. leurkopenia with white blood cell (WBC) count < 4,000/mm3 and/or anemia with hemoglobin <8g/dL and/or thrombocytopenia < 100,000/mm3) that could influence patient recovery and/or graft hemostasis
- Any active local or systemic infection (WBC > 15,000/mm3)
- Uncontrolled or poorly controlled diabetes (hemoglovin A1c > 8% despite standard care) or hospitalization for poor glucose control within the previous 6 months
- Reduced liver function, defined as: >2x the upper limit of normal for serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase; International Normalized Ratio (INR) > 1.5 or prothrombin time (PT) > 18 seconds
- Known heparin-induced thrombocytopenia
- Active bleeding disorder and/or any coagulopathy or thrombo embolic disease
- History or evidence of severe peripheral vascular disease in the upper limbs
- Known or suspected central vein obstruction on the side of planned graft implantation
- Previous dialysis access graft in the operative limb unless the aXess graft can be placed more proximally than the previous failed graft
- More than 1 failed dialysis access graft in the operative limb
- Anticipated renal transplant within 6 months
- Subjects receiving a forearm graft which crosses the elbow
- Allergies to study device (Nitinol) or agents/medication, such as contrast agents, aspirin, or clopidogrel, that cant be controlled medically
- Pregnant or breastfeeding woman or woman in fertile period not taking adequate contraceptives
- Subject is participating in another study
- Previous enrollment in this study
- Any other condition which, in the judgement of the investigator would preclude adequate evaluation for the safety and efficacy of the study conduit
Sites / Locations
- A.Z. Sint Jan
- Ziekenhuis Oost-Limburg
- UZ Ghent
- Universita degli studi dell'Insubria
- P. Stradins Clinical University Hospital
- Vilnius University Hospital Santaros Klinikos Corpus A.
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
aXess
Arm Description
Patients will be implanted with the Xeltis hemodialysis access graft (aXess)
Outcomes
Primary Outcome Measures
Freedom from device related serious adverse events
The number of patients who have a device related serious adverse event
Functional patency of graft
The number of patients with a functionally patent graft
Secondary Outcome Measures
Freedom from device related serious adverse events
The number of patients who have a device related serious adverse event
Functional patency of graft
The number of patients with a functionally patent graft
Patency (primary, primary assisted, and secondary) of graft
The number of patients with a patient graft
Time to potential central venous catheter removal
Time that patients with a central venous catheter could have had the catheter removed after the Xeltis hemodialysis access graft was placed
Time to loss of patency (primary, primary assisted, and secondary)
Number of days from implant to graft occlusion in patients who no longer have a patent graft
Rate of access related interventions required to achieve/maintain patency
Number of interventions that were performed on grafts to achieve/maintain patency
Rate of access site infections
Number of access graft sites that become infected
Proportion of hemodialysis (HD) sessions completed via central venous catheter
Number of hemodialysis sessions performed with a central venous catheter vs. the number of sessions performed with the Xeltis hemodialysis access graft
Number of days with central venous catheter in place (catheter contact time)
Number of days the patients have a central venous catheter in place irrespective of access abandonment
Pseudoaneurysm formation
Number of grafts that have a pseudoaneurysm form
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04898153
Brief Title
First-in-Human (FIH) Study of the Xeltis Hemodialysis Access Graft
Acronym
aXess-FIH
Official Title
First-in-Human (FIH) Study of the Xeltis Hemodialysis Access Graft (aXess)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 10, 2021 (Actual)
Primary Completion Date
March 24, 2023 (Actual)
Study Completion Date
September 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xeltis
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A feasibility study is to assess the preliminary safety and performance of the Xeltis hemodialysis access (aXess) graft.
Detailed Description
A prospective, single arm, non-randomized FIH feasibility study to evaluate the preliminary safety and performance of the Xeltis hemodialysis access graft in subjects older than 18 years with end-stage renal disease, who plan to undergo hemodialysis for at least the first 6 months after study access creation, and are deemed not suitable for fistula creation by the operating surgeon.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease, End Stage Renal Failure on Dialysis
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
aXess
Arm Type
Experimental
Arm Description
Patients will be implanted with the Xeltis hemodialysis access graft (aXess)
Intervention Type
Device
Intervention Name(s)
aXess
Intervention Description
Patients will be implanted with one Xeltis hemodialysis access device (aXess) in the arm
Primary Outcome Measure Information:
Title
Freedom from device related serious adverse events
Description
The number of patients who have a device related serious adverse event
Time Frame
6 months
Title
Functional patency of graft
Description
The number of patients with a functionally patent graft
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Freedom from device related serious adverse events
Description
The number of patients who have a device related serious adverse event
Time Frame
12, 18, 24, and 60 months
Title
Functional patency of graft
Description
The number of patients with a functionally patent graft
Time Frame
12, 18, 24, and 60 months
Title
Patency (primary, primary assisted, and secondary) of graft
Description
The number of patients with a patient graft
Time Frame
6, 12, 18, 24, and 60 months
Title
Time to potential central venous catheter removal
Description
Time that patients with a central venous catheter could have had the catheter removed after the Xeltis hemodialysis access graft was placed
Time Frame
Assessed retrospectively at 30 days
Title
Time to loss of patency (primary, primary assisted, and secondary)
Description
Number of days from implant to graft occlusion in patients who no longer have a patent graft
Time Frame
6, 12, 18, 24, and 60 months
Title
Rate of access related interventions required to achieve/maintain patency
Description
Number of interventions that were performed on grafts to achieve/maintain patency
Time Frame
6, 12, and 24 months
Title
Rate of access site infections
Description
Number of access graft sites that become infected
Time Frame
6, 12, and 24 months
Title
Proportion of hemodialysis (HD) sessions completed via central venous catheter
Description
Number of hemodialysis sessions performed with a central venous catheter vs. the number of sessions performed with the Xeltis hemodialysis access graft
Time Frame
12 months
Title
Number of days with central venous catheter in place (catheter contact time)
Description
Number of days the patients have a central venous catheter in place irrespective of access abandonment
Time Frame
12 months
Title
Pseudoaneurysm formation
Description
Number of grafts that have a pseudoaneurysm form
Time Frame
6, 12, and 24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects older than 18 years with end-stage renal disease (ESRD) who are not, or who are no longer, candidates for creation of an autogenous AV fistula, and therefore require placement of an AV graft in the upper extremity to start or maintain hemodialysis therapy
Suitable anatomy for the implantation of an aXess graft
The patient has been informed about the nature of the study, agrees to its provisions, and has provided written informed consent
The patient has been informed and agrees to pre- and post- procedure follow up
Life expectancy of at least 12 months
Exclusion Criteria:
History or evidence of severe cardiac disease (NHYA Functional Class IV and/or EF <30%), myocardial infarction within six months of study entry, ventricular tachyarrhythmias requiring continuing treatment, or unstable angina
Stroke within six months before study entry
Active clinically significant autoimmune / inflammatory disease, immunodeficiency (including AIDS / HIV), use of immunosuppressive therapy or medication that likely interferes with restorative therapies
Abnormal blood values (e.g. leurkopenia with white blood cell (WBC) count < 4,000/mm3 and/or anemia with hemoglobin <8g/dL and/or thrombocytopenia < 100,000/mm3) that could influence patient recovery and/or graft hemostasis
Any active local or systemic infection (WBC > 15,000/mm3)
Uncontrolled or poorly controlled diabetes (hemoglovin A1c > 8% despite standard care) or hospitalization for poor glucose control within the previous 6 months
Reduced liver function, defined as: >2x the upper limit of normal for serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase; International Normalized Ratio (INR) > 1.5 or prothrombin time (PT) > 18 seconds
Known heparin-induced thrombocytopenia
Active bleeding disorder and/or any coagulopathy or thrombo embolic disease
History or evidence of severe peripheral vascular disease in the upper limbs
Known or suspected central vein obstruction on the side of planned graft implantation
Previous dialysis access graft in the operative limb unless the aXess graft can be placed more proximally than the previous failed graft
More than 1 failed dialysis access graft in the operative limb
Anticipated renal transplant within 6 months
Subjects receiving a forearm graft which crosses the elbow
Allergies to study device (Nitinol) or agents/medication, such as contrast agents, aspirin, or clopidogrel, that cant be controlled medically
Pregnant or breastfeeding woman or woman in fertile period not taking adequate contraceptives
Subject is participating in another study
Previous enrollment in this study
Any other condition which, in the judgement of the investigator would preclude adequate evaluation for the safety and efficacy of the study conduit
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frank Vermassen, MD
Organizational Affiliation
UZ Ghent
Official's Role
Principal Investigator
Facility Information:
Facility Name
A.Z. Sint Jan
City
Brugge
Country
Belgium
Facility Name
Ziekenhuis Oost-Limburg
City
Genk
Country
Belgium
Facility Name
UZ Ghent
City
Ghent
Country
Belgium
Facility Name
Universita degli studi dell'Insubria
City
Varese
Country
Italy
Facility Name
P. Stradins Clinical University Hospital
City
Riga
Country
Latvia
Facility Name
Vilnius University Hospital Santaros Klinikos Corpus A.
City
Vilnius
Country
Lithuania
12. IPD Sharing Statement
Learn more about this trial
First-in-Human (FIH) Study of the Xeltis Hemodialysis Access Graft
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