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

Primary Purpose

Peripheral Arterial Occlusive Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
vascular grafts
Sponsored by
Maquet Cardiovascular
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Occlusive Disease

Eligibility Criteria

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

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.

Sites / Locations

  • University of Alabama-Birmingham Medical Center
  • Central Arkansas Veterans Health System
  • VA Palo Alto HCS
  • University of South Florida - Tampa General
  • Brigham and Women's Hospital
  • Beth Israel Deaconess Medical Center
  • Dartmouth- Hitchcock Medical Center
  • Albany Medical Center
  • Montefiore Weiler Hospital
  • Montefiore Medical Center
  • NYU School of Medicine
  • NY Presbyterian Hospital - Columbia Univ Medical Center
  • Dallas VA Medical Center
  • Methodist Hospital
  • Central Texas Veterans Health System
  • Scott & White
  • Norfolk Sentara - Norfolk General Hospital
  • Swedish Medical Center
  • Fakulti Nemocnice Brno
  • Fakultni Nemocnice u sv Anny v Brno
  • University Hospital Plzen
  • Vseobecna Fakultni Nemocnice (VFN) Praha
  • IKEM Praha
  • Nemocnice Na Homolce
  • Klinikum Karlsruhe

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

EXXCEL Soft

FUSION Bioline

Arm Description

A 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).

A 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.

Outcomes

Primary Outcome Measures

Number of Participants With Primary Patency
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)
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

Number of Participants With Primary Assisted Patency
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.
Number of Participants With Secondary Patency
Secondary patency was defined as patency after some form of intervention to restore and maintain blood flow after occlusion.
Time to Hemostasis of Suture Hole Bleeding (Min)
Time from the release of clamps until hemostasis, where hemostasis is defined as the absence of detectable bleeding from any of the suture holes.

Full Information

First Posted
April 28, 2010
Last Updated
May 12, 2020
Sponsor
Maquet Cardiovascular
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1. Study Identification

Unique Protocol Identification Number
NCT01113892
Brief Title
Study Comparing Synthetic Vascular Grafts in Patients With Peripheral Artery Disease (PAD) Who Require Artery Bypass.
Acronym
FINEST
Official Title
Comparison of Safety and Primary Patency Between FUSION Vascular Graft With Bioline and EXXCEL Soft ePTFE (FINEST)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
May 17, 2010 (Actual)
Primary Completion Date
December 18, 2012 (Actual)
Study Completion Date
June 4, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Maquet Cardiovascular

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Arterial Occlusive Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
This was a prospective, randomized, single-blind (subject), parallel group, multicenter study in subjects with peripheral arterial occlusive disease (PAOD) who were scheduled to undergo femoral popliteal peripheral bypass surgery. Eligible subjects were randomly assigned in a 1:1 ratio to receive either FUSION Bioline or EXXCEL vascular graft.
Masking
Participant
Masking Description
This was a single-blind study. The surgeon and study site staff knew which vascular graft each subject received, but the subject did not.
Allocation
Randomized
Enrollment
207 (Actual)

8. Arms, Groups, and Interventions

Arm Title
EXXCEL Soft
Arm Type
Active Comparator
Arm Description
A 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).
Arm Title
FUSION Bioline
Arm Type
Experimental
Arm Description
A 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.
Intervention Type
Device
Intervention Name(s)
vascular grafts
Intervention Description
All devices will be used to treat patients with peripheral arterial occlusive disease
Primary Outcome Measure Information:
Title
Number of Participants With Primary Patency
Description
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).
Time Frame
6 months
Title
The Number of Participants Meeting Composite Endpoint of Major Adverse Limb Events (MALE) and Periprocedural Death (POD)
Description
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.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Number of Participants With Primary Assisted Patency
Description
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 Frame
6 months
Title
Number of Participants With Secondary Patency
Description
Secondary patency was defined as patency after some form of intervention to restore and maintain blood flow after occlusion.
Time Frame
6 months
Title
Time to Hemostasis of Suture Hole Bleeding (Min)
Description
Time from the release of clamps until hemostasis, where hemostasis is defined as the absence of detectable bleeding from any of the suture holes.
Time Frame
Post-procedure
Other Pre-specified Outcome Measures:
Title
Number of Participants With Primary Patency
Description
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.
Time Frame
30 days
Title
Number of Participants With Primary Patency
Description
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.
Time Frame
12 months
Title
Number of Participants With Primary Assisted Patency
Description
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 Frame
30 days
Title
Number of Participants With Primary Assisted Patency
Description
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 Frame
12 months
Title
Number of Participants With Secondary Patency
Description
Secondary patency was defined as patency after some form of intervention to restore and maintain blood flow after occlusion.
Time Frame
30 days
Title
Number of Participants With Secondary Patency
Description
Secondary patency was defined as patency after some form of intervention to restore and maintain blood flow after occlusion.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alan Lumsden, MD
Organizational Affiliation
The Methodist Hospital Research Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nicholas J. Morrissey, MD
Organizational Affiliation
NY Presbyterian-Columbia U Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama-Birmingham Medical Center
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Central Arkansas Veterans Health System
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
VA Palo Alto HCS
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
University of South Florida - Tampa General
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Dartmouth- Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Albany Medical Center
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Montefiore Weiler Hospital
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
NYU School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
NY Presbyterian Hospital - Columbia Univ Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Dallas VA Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75216
Country
United States
Facility Name
Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Central Texas Veterans Health System
City
Temple
State/Province
Texas
ZIP/Postal Code
76504
Country
United States
Facility Name
Scott & White
City
Temple
State/Province
Texas
ZIP/Postal Code
76508
Country
United States
Facility Name
Norfolk Sentara - Norfolk General Hospital
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Swedish Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States
Facility Name
Fakulti Nemocnice Brno
City
Brno
ZIP/Postal Code
625 00
Country
Czechia
Facility Name
Fakultni Nemocnice u sv Anny v Brno
City
Brno
ZIP/Postal Code
656 91
Country
Czechia
Facility Name
University Hospital Plzen
City
Plzen
ZIP/Postal Code
304 60
Country
Czechia
Facility Name
Vseobecna Fakultni Nemocnice (VFN) Praha
City
Prague
ZIP/Postal Code
128 08
Country
Czechia
Facility Name
IKEM Praha
City
Prague
ZIP/Postal Code
140 21
Country
Czechia
Facility Name
Nemocnice Na Homolce
City
Prague
ZIP/Postal Code
150 30
Country
Czechia
Facility Name
Klinikum Karlsruhe
City
Karlsruhe
ZIP/Postal Code
76133
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
25720929
Citation
Lumsden AB, Morrissey NJ; Comparison of Safety and Primary Patency Between the FUSION BIOLINE Heparin-Coated Vascular Graft and EXXCEL Soft ePTFE (FINEST) Trial Co-investigators. Randomized controlled trial comparing the safety and efficacy between the FUSION BIOLINE heparin-coated vascular graft and the standard expanded polytetrafluoroethylene graft for femoropopliteal bypass. J Vasc Surg. 2015 Mar;61(3):703-12.e1. doi: 10.1016/j.jvs.2014.10.008. Erratum In: J Vasc Surg. 2015 May;61(5):1382.
Results Reference
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Learn more about this trial

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

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