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StenosisAVeNEWNCT02649946

Clinical Study of the BARD® COVERA™ Arteriovenous (AV) Stent Graft

A study testing Covera Vascular Covered Stent following PTA and Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon in people with Stenosis and Restenosis, run by C. R. Bard at 24 sites in 8 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study is to assess the safety and effectiveness of the COVERA™ Vascular Covered Stent for the treatment of stenotic lesions in the upper extremity venous outflow of the Arteriovenous (AV) access circuit. Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Stenosis, Restenosis
What is being tested?
Covera Vascular Covered Stent following PTA and Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon
Could I receive a placebo?
No, everyone receives an active treatment
How many people
280 participants
Where
24 sitesin 8 countries
Study dates
Jun 2016to Feb 2021
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Clinical Inclusion Criteria:

  • Subject must voluntarily sign and date the Informed Consent Form (ICF) prior to collection of study data or performance of study procedures.
  • Subject must be either a male or non-pregnant female ≥ 21 years of age with an expected lifespan sufficient to allow for completion of all study procedures.
  • Subject must be willing to comply with the protocol requirements, including the clinical and telephone follow-up.
  • Subject must have an upper extremity arteriovenous (AV) fistula that has undergone at least one successful dialysis session with two-needle cannulation, prior to the index procedure.

Angiographic Inclusion Criteria:

  • Subject must have angiographic evidence of a stenosis ≥ 50% (by visual estimation) located in the venous outflow of the AV access circuit and present with clinical or hemodynamic evidence of AV fistula dysfunction.
  • The target lesion must be ≤ 9cm in length. Note: multiple stenoses may exist within the target lesion.
  • The reference vessel diameter of the adjacent non-stenotic vein must be between 5.0 and 9.0mm.

Clinical Exclusion Criteria:

  • The subject is dialyzing with an AV graft.
  • The target lesion has had a corresponding thrombosis treated within 7 days prior to the index procedure.
  • The hemodialysis access is located in the lower extremity.
  • The subject has an infected AV fistula or uncontrolled systemic infection.
  • The subject has a known uncontrolled blood coagulation/bleeding disorder.
  • The subject has a known allergy or hypersensitivity to contrast media which cannot be adequately pre-medicated.
  • The subject has a known hypersensitivity to nickel-titanium (Nitinol) or tantalum.
  • The subject has another medical condition, which, in the opinion of the Investigator, may cause him/her to be non-compliant with the protocol, confound the data interpretation, or is associated with a life expectancy insufficient to allow for the completion of study procedures and follow-up.
  • The subject is currently participating in an investigational drug or another device study that has not completed the study treatment or that clinically interferes with the study endpoints. Note: Studies requiring extended follow-up visits for products that were investigational, but have since become commercially available, are not considered investigational studies.

Angiographic Exclusion Criteria:

  • Additional stenotic lesions (≥ 50%) in the venous outflow that are > 3cm from the edge of the target lesion and are not successfully treated (defined as < 30% residual stenosis) prior to treating the target lesion.
  • An aneurysm or pseudoaneurysm is present within the target lesion.
  • The location of the target lesion would require the COVERA™ Vascular Covered Stent be deployed across the elbow joint.
  • The target lesion is located within a stent.
  • The location of the target lesion would require that the COVERA™ Vascular Covered Stent be deployed at or across the segment of fistula utilized for dialysis needle puncture (i.e., "cannulation zone").
  • The location of the target lesion would require that the COVERA™ Vascular Covered Stent be placed in the central veins (subclavian, brachiocephalic, superior vena cava (SVC)) or under the clavicle at the thoracic outlet.
  • There is incomplete expansion of an appropriately sized angioplasty balloon to its expected profile, in the operator's judgment, during primary angioplasty at the target lesion prior to randomization.

Trial locations and contacts

24 sites in 8 countries.

24 sites in 8 countries

United States16 sites
  • Chicago Access Care

    Chicago, Illinois, 60521

  • Radiology Imaging Associates

    Englewood, Colorado, 80112

  • Tarrant Vascular Clinic

    Fort Worth, Texas, 76104

  • Indiana University Hospital

    Indianapolis, Indiana, 46202

  • Jacksonville Center for Clinical Research

    Jacksonville, Florida, 32207

  • First Coast Cardiovascular Institute

    Jacksonville, Florida, 32216

  • Alliance Research Centers

    Laguna Hills, California, 92653

  • Yale University & Yale New Haven Hospital

    New Haven, Connecticut, 06520

  • Nephrology Associates, P.A.

    Newark, Delaware, 19713

  • Ocala Kidney Group

    Ocala, Florida, 34471

  • Providence Access Care

    Providence, Rhode Island, 02906

  • NC Heart and Vascular Research

    Raleigh, North Carolina, 27607

  • NC Nephrology

    Raleigh, North Carolina, 27610

  • Clinical Advancement Center, PLLC

    San Antonio, Texas, 78215

  • Southwest Vascular Center

    Tempe, Arizona, 85281

  • Renal and Transplant Associates of New England, P.C.

    West Springfield, Massachusetts, 01089

Other trials in United States

Australia2 sites
  • Flinders Medical Centre

    Bedford Park, South Australia, 5042

  • Royal Adelaide Hospital

    Kensington Gardens, South Australia, 5068

Other trials in Australia

Austria1 site
  • LKH-Univ. Klinikum Graz

    Graz, 8036

Other trials in Austria

Belgium1 site
  • University Hospital Leuven

    Leuven, Vlaams-Brabant, 3000

Other trials in Belgium

Germany1 site
  • Universitätsklinikum Würzburg

    Würzburg, 97080

Other trials in Germany

Netherlands1 site
  • Maastricht Universitair Medish Centrum

    Maastricht, 6202

Other trials in Netherlands

New Zealand1 site
  • Middlemore Hospital

    Auckland, 2025

Other trials in New Zealand

Switzerland1 site
  • Universitaets Spital Zurich

    Zurich, 8091

Other trials in Switzerland

About this study

Official title: A Prospective, Multi-Center, Randomized, Concurrently-Controlled Clinical Study of the BARD® COVERA™ Arteriovenous (AV) Stent Graft in the Treatment of Stenosis in the Venous Outflow of AV Fistula Access Circuits (AVeNEW)

The objective of this study is to assess the safety and effectiveness of the COVERA™ Vascular Covered Stent for the treatment of stenotic lesions in the upper extremity venous outflow of the Arteriovenous (AV) access circuit.

Read the detailed description

This study will compare the use of the COVERA™ Vascular Covered Stent (following percutaneous transluminal angioplasty (PTA)) to PTA alone for the treatment of stenotic lesions in the upper extremity venous outflow of the arteriovenous (AV) access circuit of subjects dialyzing with an AV fistula.

Conditions
Stenosis, Restenosis
Being tested
Covera Vascular Covered Stent following PTA, Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon
Keywords
ESRD, Stenosis, Restenosis, Hemodialysis, AV Fistula, Arteriovenous (AV)
Medical subject headings
Constriction, Pathologic, Kidney Failure, Chronic, Arteriovenous Fistula

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Covera Vascular Covered Stent following PTADevice

    Treatment of stenoses with primary percutaneous transluminal angioplasty (PTA) and placement of the Covera Vascular Covered Stent.

  • Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA BalloonProcedure or surgery

    Also called Standard Balloon Angioplasty (POBA)

    Treatment of stenoses with PTA only

Study groups in NCT02649946
Study groupRoleWhat they receive
Covera Vascular Covered Stent following PTAExperimentalPlacement of the Covera Vascular Covered Stent following percutaneous transluminal angioplasty (PTA)
Receives: Device: Covera Vascular Covered Stent following PTA
PTA only using uncoated PTA BalloonActive comparatorPercutaneous Transluminal Angioplasty (PTA) will be performed using a commercially available uncoated PTA balloon. Balloons with an external wire support, cutting/scoring component or other similar modifications are not permitted. Multiple balloons, inflations and/or prolonged inflation may be used.
Receives: Procedure: Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Effectiveness Endpoint: Number of Participants With Target Lesion Primary Patency (TLPP)

    TLPP is defined as the interval following the index intervention until the next clinically driven reintervention at, or adjacent to,the original treatment site or until the extremity is abandoned for permanent access. Primary patency ends when any of the following occurs: a) clinically driven reintervention in the treatment area; b) thrombotic occlusion within the treatment area; c) surgical intervention that excludes the original treatment area from the AV circuit, and/or d) abandonment of the AV fistula due to inability to treat the original treatment area. COVERA Vascular Covered Stent (following PTA) is evaluated against subjects treated PTA alone.

    Measured: 6 months post index procedure

  2. Number of Participants With Freedom From AV Access Circuit Localized or Systemic Serious Adverse Events

    Safety is defined as freedom from any adverse event(s) (AEs), localized or systemic, that reasonably suggests the involvement of the AV access circuit (not including stenosis or thrombosis) that require or result in any of the following alone or in combination: additional interventions (including surgery); in-patient hospitalization or prolongation of an existing hospitalization; or death.

    Measured: 30 days post index procedure

Secondary outcomes (12)
  1. Number of Patients With Target Lesion Primary Patency (TLPP) at 12 Months Post Index Procedure

    TLPP is defined as the interval following the index intervention until the next clinically driven reintervention at the original treatment site or until the extremity is abandoned for permanent access. Primary patency ends when any of the following occurs: a) clinically driven reintervention in the treatment area; b) thrombotic occlusion within the treatment area; c) surgical intervention that excludes the original treatment area from the AV circuit, and/or d) abandonment of the AV fistula due to inability to treat the original treatment area.

    Measured: 12 months post-index procedure

  2. Number of Participants With Access Circuit Primary Patency (ACPP).

    ACPP is defined as the interval following the index intervention until the next access thrombosis or repeated intervention.

    ACPP ends with a reintervention anywhere within the access circuit. Vessel rupture caused by PTA is not an ACPP failure unless achieving hemostasis also causes thrombosis.

    Testing of this secondary endpoint is performed in a hierarchical fashion. Thus, In order to perform hypothesis test of ACPP at 6-month, TLPP at 12-months must be successful.

    Measured: 6 months post index procedure

  3. Number of Participants With Target Lesion Primary Patency (TLPP)

    Defined as the interval following the index intervention until the next clinically driven reintervention at the original treatment site or until the extremity is abandoned for permanent access.

    mITT subjects results are presented. N= number of subjects in the mITT Population with evaluable data. Evaluation through 1, 3, 18 and 24 months post index procedure.

    Measured: 1, 3, 18 and 24 months post index procedure

  4. Number of Participants With Access Circuit Primary Patency (ACPP)

    ACPP is defined as the interval following the index intervention until the next access thrombosis or repeated intervention.

    N = number of subjects in the mITT Population with evaluable data.

    Measured: 1, 3, 12, 18, and 24 months post index procedure

  5. Number of Participants Free From Device and Procedure Related AEs Involving the AV Access Circuit

    Number of Participants Free from Device and Procedure Related AEs Involving the AV Access Circuit (ITT population).

    Number of participants (n) in each follow-up periods varies from overall enrollment (N) as some subjects discontinued participation before the 30 days, 90 days and 6 months follow-up or did not meet endpoint inclusion criteria.

    The relationships with device/procedure of the events are based on CEC adjudications.

    Measured: Evaluation through 1, 3, 6, 12, 18, and 24 months post-index procedure

  6. Total Number of Arteriovenous (AV) Access Circuit Reinterventions

    Defined as the number of reinterventions to the AV access circuit until access abandonment or through study completion.

    Whereas the outcome measure time frames for the overall study are 1, 3, 6, 12,18 and 24 months, the interim report only provides the 1, 3, and 6 months results. The 12,18 and 24 months results will be provided in the final reporting for the study.

    MITT results are presented for this analysis.

    Measured: 1, 3, 6, 12, 18 and 24 months post index procedure

  7. Total Number of Target Lesion Reinterventions

    Total Number of Target Lesion Reinterventions defined as the number of reinterventions to maintain target lesion patency (mITT subjects).

    Whereas the outcome measure time frames for the overall study are 1, 3, 6, 12,18 and 24 months.

    Measured: 1, 3, 6, 12, 18 and 24 months post index procedure

  8. Index of Patency Function (IPF)

    IPF is defined as the time from the index study procedure to study completion or access abandonment divided by the number of visits for a reintervention performed on the AV access circuit in order to maintain vascular access for hemodialysis. A visit is defined as one (1) procedural event, regardless of the number or type of interventions performed during the visit. The index procedure is counted as the first visit to ensure all subjects have a denominator of at least one.

    Whereas the measure time frames for the overall study are 1, 3, 6, 12,18 and 24 months.

    The IPF is representative of the number of days between interventions to maintain access circuit patency. Higher values represent a better outcome, that is, more time elapsed between the Index study procedure and reinterventions.

    mITT results are analyzed.

    Measured: 1, 3, 6, 12, 18 and 24 months post index procedure

  9. Index of Patency Function - Target Lesion (IPF-T)

    IPF-T (Index of Patency Function - Target Lesion) is defined as the time from the index study procedure to study completion or complete access abandonment divided by the number of visits for a reintervention performed at the target lesion in order to maintain vascular access for hemodialysis.

    Whereas the measure time frames for the overall study are 1, 3, 6, 12, 18 and 24 months.

    The IPF for target lesion patency is representative of the approximate (mean) number of days between interventions to maintain target lesion patency. Higher values represent a better outcome, that is, more time elapsed between the Index study procedure and reinterventions.

    Measured: 1, 3, 6, 12, 18 and 24 months post index procedure

  10. Number of Participants With Post-intervention Secondary Patency

    Secondary Patency is defined as the interval after the index intervention until the access is abandoned. Multiple repetitive treatments can be included in post-intervention secondary patency.

    Whereas the measure time frames for the overall study are 1, 3, 6, 12,18 and 24 months, the interim report only provides the 1, 3, and 6 months results. The 12,18 and 24 months results will be provided in the final reporting for the study.

    mITT subjects results are presented.

    Measured: 1, 3, 6, 12, 18 and 24 months post index procedure

  11. Number of Participants With Technical Success

    Technical Success is defined as successful deployment, based on the operator's opinion, of the implant to the intended location assessed at the time of the index procedure. Therefore, for this measure, only COVERA data are relevant.

    mITT results are presented. Number of participants (n) included in this analysis is different from overall enrollment (N) as some subjects discontinued participation before the 30 days, 90 days and 6 months follow-up or did not meet endpoint inclusion criteria.

    Technical success was assessed on the day the index procedure was performed, which may be a different day for each participant.

    Measured: On Day of Index Procedure

  12. Number of Participants With Procedure Success

    Procedure Success is defined as anatomic success and resolution of the pre-procedural clinical indicator(s) (clinical success) of a hemodynamically significant stenosis.

    Procedure success was assessed on the day the index procedure was performed, which may be a different day for each participant.

    Measured: On Day of Index Procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jan 2016 (estimated)
  2. Study startJun 2016
  3. Primary completionAug 2018
  4. Study completionFeb 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
280 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02649946
Sponsor's protocol ID
BPV-14-005
Acronym
AVeNEW
Status last verified
Dec 2021
First submitted
4 Jan 2016
Last updated
21 Dec 2021
Data monitoring committee
Yes

Publications

  • Dolmatch B, Cabrera T, Pergola P, Balamuthusamy S, Makris A, Cooper R, Moore E, Licht J, Macaulay E, Maleux G, Pfammatter T, Settlage R, Cristea E, Lansky A; AVeNEW Trial Investigators. Prospective, randomized, multicenter clinical study comparing a self-expanding covered stent to percutaneous transluminal angioplasty for treatment of upper extremity hemodialysis arteriovenous fistula stenosis. Kidney Int. 2023 Jul;104(1):189-200. doi: 10.1016/j.kint.2023.03.015. Epub 2023 Mar 27.

    PubMed 36990214

Questions about this trial

What is this clinical trial studying?

A study testing Covera Vascular Covered Stent following PTA and Percutaneous Transluminal Angioplasty (PTA) with Uncoated PTA Balloon in people with Stenosis and Restenosis, run by C. R. Bard at 24 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in United States, Australia, Austria, Belgium, Germany and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Effectiveness Endpoint: Number of Participants With Target Lesion Primary Patency (TLPP) (time frame: 6 months post index procedure). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02649946, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Dec 2021.

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