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The primary study objective is to evaluate the benefit of the Sirolimus eluting Collagen implant (SeCI; Sirogen), a single dose prophylactic treatment delivered intraoperatively at the time of surgical creation of an arteriovenous fistula for hemodialysis vascular access.
This is a Phase 3, multicenter, randomized, single-blind, controlled, study designed to evaluate the efficacy and safety of the use of the Sirolimus-eluting Collagen Implant (SeCI) in subjects who are on hemodialysis and are undergoing surgical creation of an AV fistula in comparison to subjects who do not receive the implant.
Subjects of either gender, who are at least 65 years of age, undergoing hemodialysis, and require a new single stage radiocephalic end to side fistula will be eligible to participate in this study. Subjects who meet eligibility criteria and undergo successful AV fistula creation will be eligible for enrollment. The study plans to enroll approximately 120 subjects, randomized in a 1:1 ratio. Enrolled subjects will be followed for a period of one year from the time of their index surgical procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment Arm | Experimental | Subjects randomized to the treatment arm will undergo AV fistula surgery and will receive the Sirolimus eluting Collagen Implant (SeCI). |
|
| Control Arm | No Intervention | Subjects randomized to the control arm will undergo AV fistula surgery alone and will not receive an implant. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sirolimus | Drug | SeCI placed at and around the site of the anastomosis of an AV fistula, immediately following completion of a successful AV fistula surgery. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Fistula Maturation (FM) | Clinical Fistula Maturation (FM) is defined as a fistula that can be cannulated with 2-needles for at least 75% of the dialysis sessions, including 3 consecutive sessions with a mean Qb of 300 mL/min (unless the prescribed Qb is <300 mL/min) performed during any continuous 30 day period that commences no later than 180 days after randomization. The primary endpoint will be summarized as a time-to-event endpoint for the SeCI (Sirogen) and control groups by reporting the cumulative proportion of AVF that achieve FM over time [defined as the interval from access placement to the first session that the fistula can be cannulated with 2 needles (contributing to the FM definition)]. | 6 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Fistula Suitability for Dialysis at 12 months (FSD12) | Fistula Suitability for Dialysis at 12 months (FSD12) defined as a fistula that can be used for dialysis using 2 needles for at least 75% of the dialysis sessions performed during a 30 day period that commences on day 330. | 1 year |
| Secondary Patency (SP) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sriram Iyer, MD | Vascular Therapies, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Veterans Affairs San Diego Health Center | San Diego | California | 92161 | United States | ||
| Lundquist Institute for Biomedical Innovation |
Individual participant data (IPD) collected in this study will not be shared.
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|
Secondary Patency (SP) defined as the interval from the time of randomization until access abandonment. |
| 1 year |
| Time To First Dialysis (TTFD) | Time To First Dialysis (TTFD) defined as the interval from the time of randomization to the first of three consecutive dialysis sessions using 2 needles with a mean Qb of ≥300 mL/min (unless the prescribed Qb is <300 mL/min). | 1 year |
| Mature Fistula with Preserved Function at 12 Months (MFPF) | Mature Fistula with Preserved Function at 12 Months (MFPF) defined as a fistula that can be cannulated with 2 needles for at least 75% of the dialysis sessions, including 3 consecutive sessions with a mean Qb of ≥300 mL/min (unless the prescribed Qb is <300 mL/min) performed during any continuous 30-day period that commences no later than 180 days after randomization (i.e., fistula achieves FM) AND can be used for dialysis using 2-needles for at least 75% of the for the dialysis sessions performed during a 30-day period that commences on day 330 (FSD12). | 1 year |
| Durable Fistula Maturation (DFM) | Durable Fistula Maturation (DFM) defined as a fistula that can be cannulated with 2 needles for at least 75% of the dialysis sessions, including 3 consecutive sessions with a mean Qb of ≥300 mL/min performed during any continuous 30-day period that commences no later than 180 days after randomization (i.e., fistula achieves FM) AND can be used for dialysis using 2-needles with a mean Qb of ≥300 mL/min for the dialysis sessions performed during a 30-day period that commences on day 330. | 1 year |
| Cumulative Fistula Use (CFU) | Cumulative Fistula Use (CFU) defined as the number of dialysis sessions performed using the study fistula with 2 needles and a mean Qb of ≥300 mL/min. CFU is calculated from the time of fistula creation to the end of study period or upon reaching an intercurrent event (Fistula abandonment, Death, Transfer to PD or transplant) or is lost to follow up. | 1 year |
| Cumulative Catheter Exposure (CCE) | Cumulative Catheter Exposure (CCE) is defined as the number of days a hemodialysis central venous catheter (CVC) is in situ and the duration of CVC exposure is calculated from the day of fistula creation (i.e., day of randomization) to the end of study period or upon reaching an intercurrent event. | 1 year |
| Torrance |
| California |
| 90502 |
| United States |
| MedStar Cardiovascular Research Network at MedStar Washington Hospital Center | Washington D.C. | District of Columbia | 20010 | United States |
| American Access Care of Miami | Miami | Florida | 33156 | United States |
| Emory University Hospital Midtown | Atlanta | Georgia | 30308 | United States |
| Augusta University | Augusta | Georgia | 30912 | United States |
| University of Louisville | Louisville | Kentucky | 40202 | United States |
| The Brigham and Women's Hospital | Boston | Massachusetts | 02115 | United States |
| Mount Sinai Hospital | New York | New York | 10029 | United States |
| Atrium Health | Charlotte | North Carolina | 28204 | United States |
| Surgical Specialists of Charlotte | Charlotte | North Carolina | 28207 | United States |
| The Regional Medical Center/Dialysis Access Institute | Orangeburg | South Carolina | 29118 | United States |
| James Eric Gardner, MD PC | Memphis | Tennessee | 38115 | United States |
| Arteries & Veins | El Paso | Texas | 79912 | United States |
| Houston Methodist | Houston | Texas | 77030 | United States |
| Houston Methodist | Sugar Land | Texas | 77479 | United States |
| Sentara Norfolk General Hospital/Sentara Health Research Center | Norfolk | Virginia | 23507 | United States |
| University Hospitals Birmingham NHS Foundation Trust | Birmingham | United Kingdom |
| St Helier Hospital | Carshalton | SM5 1AA | United Kingdom |
| NHS Greater Glasgow and Clyde | Glasgow | United Kingdom |
| Barts Health NHS Trust of Royal London Hospital | London | United Kingdom |
| St George's University Hospitals NHS Foundation Trust | London | United Kingdom |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 21, 2025 | Jan 13, 2026 | 12 | ||
| Jan 14, 2026 | Jan 30, 2026 | 13 | ||
| Feb 11, 2026 | Mar 6, 2026 | 14 | ||
| Apr 16, 2026 | May 6, 2026 | 15 |
| ID | Term |
|---|---|
| D007676 | Kidney Failure, Chronic |
| D001164 | Arteriovenous Fistula |
| ID | Term |
|---|---|
| D051436 | Renal Insufficiency, Chronic |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001165 | Arteriovenous Malformations |
| D054079 | Vascular Malformations |
| D018376 | Cardiovascular Abnormalities |
| D002318 | Cardiovascular Diseases |
| D016157 | Vascular Fistula |
| D014652 | Vascular Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D005402 | Fistula |
| D020763 | Pathological Conditions, Anatomical |
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| ID | Term |
|---|---|
| D020123 | Sirolimus |
| ID | Term |
|---|---|
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
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