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Status unknownNCT03405233ePTFEUpdated Feb 14, 2018

Role of Double Cuffed PTFE Arteriovenous Grafts in Enhancing Long-term Patency in Hemodialysis Patients (Extended Poly Tetra Fluoro Ethylene)

An interventional study of Double vein cuffed ePTFE graft both at the inflow and outflow ends and single vein cuffed eTFE graft both at the inflow and outflow ends in End Stage Renal Disease, sponsored by Mansoura University. Status unknown at 1 site in Egypt. Per ClinicalTrials.gov, last updated 2018-02-14.

Sponsored by Mansoura University · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Feb 2018), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
220
Allocation
Randomized
Sex
All
01

Study summary

this randomized controlled trial will compare the double vein cuffed synthetic arteriovenous graft to the single vein cuffed synthetic and the non cuffed synthetic as regard to long-term patency of each modality

Read the detailed description

End-stage renal disease (ESRD) arises from many heterogeneous disease pathways that alter the function and structure of the kidney irreversibly, over months or years.End-stage renal disease (ESRD) arises from many heterogeneous disease pathways that alter the function and structure of the kidney irreversibly, over months or years. Haemodialysis (HD) is a lifeline therapy for patients with ESRD. A proportion of hemodialysis patients exhaust all options for permanent vascular access (fistula or graft) in both upper extremities.ePTFE grafts are easily subjected to graft outflow tract intimal hyperplasia, which may lead to graft outlet stenosis and graft thrombosis after a certain period of usage. The commonest cause of PTFE graft failure is intimal hyperplasia (IH) at the venous anastomoses. our study aims to evaluate the influence of double cuffed ePTFE grafts with autologous vein cuffs on the long-term patency of dialysis access, and compare the clinical patency and the complications occurring with the usage of the double cuffed graft to that with standard non cuffed grafts in chronic renal hemodialysis therapy.

this randomized controlled trial will compare the double vein cuffed synthetic arteriovenous graft to the single vein cuffed synthetic and the non cuffed synthetic as regard to long term patency of each modality

02

Conditions studied

  • End Stage Renal Disease

Keywords

  • ESRD
  • ePTFE
  • neointemal hyperplasia
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Patients with end stage renal diseases and GFR less than 30
  2. By clinical examination in ability to palpate distal or proximal upper limb veins 3. By duplex examination the diameter of cephalic or basilic veins are less than 3 mm or reported to be incompressible 4. Patients with previous history of failed attempts of autogenous vein creation 5. Patients with border line cephalic or basilica vein (3mm) and on intraoperative the vein diameter appears to be unsuitable (less than 3 mm).

Exclusion criteria

Exclusion Criteria:

  1. All patients with palpable suitable forearm or arm veins
  2. Patients with baseline blood pressure less than 110/70
  3. Brachial artery of diameter less than 4 mm
  4. Patients with ligated brachial artery
  5. Patients with history of central vein stenosis
  6. Patients with immunodeficiency states
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
220 participants (estimated)

Study arms

  • Experimental
    Group A

    Double vein cuff PTFE graft both at the inflow and outflow ends

    Procedure: Double vein cuffed ePTFE graft both at the inflow and outflow ends

  • Active comparator
    Group B

    Single vein cuffed PTFE graft at the outflow end

    Procedure: single vein cuffed eTFE graft both at the inflow and outflow ends

  • Active comparator
    Group C

    PTFE graft without vein cuff will be used

    Procedure: ePTFE graft without any cuff

Interventions

  • ProcedureDouble vein cuffed ePTFE graft both at the inflow and outflow ends

    Vein cuff is obtained from a segment of one of the arm veins (cephalic or basilica) after incising it longitudinally and wrapped around both ends of PTFE Graft

  • Proceduresingle vein cuffed eTFE graft both at the inflow and outflow ends

    Vein cuff is obtained from a segment of one of the arm veins (cephalic or basilica) after incising it longitudinally and wrapped around the venous end of PTFE Graft

  • ProcedureePTFE graft without any cuff

    anastmosis between arterial and venous side usinf non cuffed ePTFE graft

05

What researchers measure

Primary outcomes

  1. primary patency

    comparing primary patency between the double cuffed, single cuffed and non cuffed ePTFE graft primary patency means how long will the graft be patent after the first intervention

    Time frame: 2 years for each patient after the operation

Secondary outcomes

  1. secondary patency

    comparing secondary patency between the double cuffed, single cuffed and non cuffed ePTFE graft secondary patency means how long will the graft be patent after thormobectomy to a thrombosed graft

    Time frame: 2 years after restoration of patency

06

Study locations

1 of 1 sites recruiting
  • Mansoura faculty of medicine
    Mansourah, Delta 35516, Egypt
    Recruiting
07

References and documents

Publications

  • Cheng C, Tempel D, van Haperen R, van der Baan A, Grosveld F, Daemen MJ, Krams R, de Crom R. Atherosclerotic lesion size and vulnerability are determined by patterns of fluid shear stress. Circulation. 2006 Jun 13;113(23):2744-53. doi: 10.1161/CIRCULATIONAHA.105.590018. Epub 2006 Jun 5. PubMed 16754802 ↗
  • Ghonemy TA, Farag SE, Soliman SA, El-okely A, El-hendy Y. Epidemiology and risk factors of chronic kidney disease in the El-Sharkia Governorate, Egypt. Saudi J Kidney Dis Transpl. 2016 Jan;27(1):111-7. doi: 10.4103/1319-2442.174137. PubMed 26787576 ↗
  • Ong S, Barker-Finkel J, Allon M. Long-term outcomes of arteriovenous thigh grafts in hemodialysis patients: a comparison with tunneled dialysis catheters. Clin J Am Soc Nephrol. 2013 May;8(5):804-9. doi: 10.2215/CJN.09240912. Epub 2013 Jan 31. PubMed 23371958 ↗
  • Tsoulfas G, Hertl M, Ko DS, Elias N, Delmonico FL, Romano L, Fernandes I, Schoenfeld D, Kawai T. Long-term outcome of a cuffed expanded PTFE graft for hemodialysis vascular access. World J Surg. 2008 Aug;32(8):1827-31. doi: 10.1007/s00268-008-9514-z. PubMed 18343971 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03405233
Lead sponsor
Mansoura University
Responsible party
Amr Elshafie (Assistant Lecturer of vascular surgery, Mansoura University) — Principal investigator
First posted
Jan 23, 2018
Start date
Feb 1, 2018
Primary completion
Jan 31, 2023 (estimated)
Completion
Jan 31, 2023 (estimated)
Last update
Feb 14, 2018

Study contacts

Hussein mohamed Abdelaziz, PHD
Contact
menhag@mans.edu.eg
+201002421140 ext. +2

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Feb 2018. You cannot join it, but the record below documents what was studied.

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