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The purpose of this exploratory study is to evaluate safety and effectiveness of treatment of juxta-anastomotic (re)stenosis with SUPERA stent by improving hemodynamic situation through obtuse shaping of the anastomosis.
Up to 50 patients undergoing percutaneous intervention due to juxta-anastomotic (re-)stenosis of the AV fistulas will be enrolled in this single-arm, prospective, multi-center CE marked study (IIT). Hemodialysis patients with failing radial-cephalic arteriovenous fistula (AVF) will receive treatment with the SUPERA stent and will be followed-up at 1, 3, 6 and 12 months after the procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SUPERA peripheral stent system |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Superaâ„¢ Peripheral Stent System | Device | The device will be employed for treatment of juxta-anastomotic stenosis in failing AV fistula after previous percutaneous angioplasty procedures |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with primary patency of juxta-anastomose at month 3 | Primary patency is defined as clinically assessed intervention free (IFP) period | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with primary patency of juxta-anastomose | Primary patency is defined as clinically assessed intervention free (IFP) period | 1, 6 and 12 months. |
| Number of patients with assisted primary patency |
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Inclusion Criteria:
Exclusion Criteria:
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Hemodialysis patients from clinics with vascular centers
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| Name | Affiliation | Role |
|---|---|---|
| Michael Lichtenberg, Dr.med. | Klinikum Hochsauerland GmbH | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Klinikum Hochsauerland GmbH | Arnsberg | 59759 | Germany |
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Assisted primary patency is defined as interval until access thrombosis or the time of measurement of patency, including intervening manipulations (surgical or endovascular interventions) designed to maintain the functionality of a patent access
| 1, 3, 6 and 12 months |
| Number of patients with secondary patency | Secondary patency is defined as interval until access abandonment, thrombosis, or the time of patency measurement including intervening manipulations (surgical or endovascular interventions) designed to reestablish functionality in thrombosed access | 1, 3, 6 and 12 months |
| Number of patients with technical success | Residual stenosis < 30% after treatment with Supera stent (measured by angiography during the procedure) | Day 1 after the index procedure |
| Number of patients with procedural success | Residual stenosis < 30% with no major adverse events (MAE) | 1 day (discharge) |
| Number of patients with clinical success | Hemodialysis access function improved, dialysis function restored, and at least one dialysis session completed after the procedure until discharge | 1 day (discharge) |
| Number of patients with access circuit patency | Freedom from development of a stenosis in any region of the AVF circuit, including the juxta-anastomotic segment | 1,3,6,12 months |
| Recirculation rate | 1, 3, 6 and 12 months |
| Fistula flow | Flow in AV fistula measured with ultrasound | 1, 3, 6 and 12 months |
| Incidence of major adverse events | Major adverse events (death, stroke) | 6 and 12 months |