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Arteriovenous Fistula StenosisNCT03041467

IN.PACT™ AV Access IDE Study

A study testing IN.PACT AV DCB and Standard Balloon Angioplasty in people with Arteriovenous Fistula Stenosis and Arteriovenous Fistula Occlusion, run by Medtronic Endovascular at 29 sites in 3 countries.

Completed

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

Official record
Search all trials

Trial summary

To evaluate the safety and efficacy of the IN.PACT™ AV Access Drug Coated Balloon (DCB) compared to percutaneous transluminal angioplasty (PTA) for treatment of subjects presenting with de novo or non-stented restenotic obstructive lesion of native arteriovenous dialysis fistulae (AVF) in the upper extremity. Read more about this study

Who is it for?
Ages 21 years and older
What is being tested?
IN.PACT AV DCB and Standard Balloon Angioplasty
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
330 participants
Where
29 sitesin 3 countries
Study dates
25 Apr 2017to 5 May 2023
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

Who may be able to join

  • Patient is ≥21 years of age.
  • Patient has a life expectancy of ≥ 12 months
  • Patient has a native AV fistula created ≥ 60 days prior to the index procedure
  • The target AV fistula has undergone successful dialysis for at least 8 of 12 sessions during a four week period
  • Patient has a de novo and/or non-stented restenotic lesion located between the arteriovenous anastomosis and axillosubclavian junction with ≥50% stenosis. Note: If the lesion is located in the anastomosis, the treatment may be delivered up to 2 cm upstream on the arterial side. If the lesion is located in the cephalic arch, the treatment may be delivered up to 2 cm into the subclavian vein
  • Patient has a target lesion or a tandem lesion that is ≤ 100 mm in length (by visual estimate) Note: Tandem lesions may be enrolled provided they meet all of the following criteria: Separated by a gap of ≤ 30mm (3 cm), total combined lesion length, including 30 mm gap, ≤ 100 mm, and able to be treated as a single lesion
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  • Patient has a target vessel diameter of 4.0 - 12.0 mm (by visual estimate).
  • Patient underwent successful crossing of the target lesion with the guide wire and pre-dilatation with a high pressure PTA balloon defined as: residual stenosis of ≤ 30% and absence of a flow limiting dissection (Grade ≥ C) or perforation
  • Patient provides written consent prior to enrollment in the study
  • Patient is willing to comply with all follow-up evaluations at specified times

Who cannot join

  • Women who are breastfeeding, pregnant, or are intending to become pregnant, or men intending to father children
  • Patient is receiving immunosuppressive therapy
  • Patient is anticipating a kidney transplant within 6 months of enrollment into the study
  • Patient has undergone prior intervention of access site within 30 days of index procedure
  • Patient with anticipated conversion to peritoneal dialysis
  • Patient has an infected AV access or systemic infection
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  • Patient has planned surgical revision of access site
  • Patient with secondary non-target lesion requiring treatment within 30-days post index procedure
  • Patient with hemodynamically significant central venous stenoses that cannot be successfully treated prior to treatment of the target lesion
  • Patient with target AVF or access circuit which previously had or currently has a thrombosis
  • Patients judged to have a lesion that prevents complete inflation of an angioplasty balloon or proper placement of the delivery system
  • Patient with target lesion located central to the axillosubclavian junction
  • Patient has significant arterial inflow lesion requiring treatment more than 2 cm upstream from the anastomosis in the AV access
  • Patient has presence of pseudoaneurysm or aneurysm requiring treatment at the lesion site
  • Patient has presence of a stent located in the target AV access circuit
  • Patients with known allergies or sensitivities to paclitaxel
  • Patient with known contraindication, including allergic reaction, or sensitivity to contrast material that cannot be adequately pre-treated
  • Patient who cannot receive recommended antiplatelet and/or anticoagulant therapy
  • Patient with clinically significant Steal Syndrome requiring treatment
  • Patient is enrolled in another investigational drug, device, or biological study and has not completed the primary endpoint, or was previously enrolled in this study
  • Patient has a comorbid-condition that, in the judgment of the Investigator, may cause him/her to be non-compliant with the protocol of confound data interpretation

Trial locations and contacts

29 sites in 3 countries.

29 sites in 3 countries

United States21 sites
  • King's Daughters Medical Center

    Ashland, Kentucky, 41101

  • University of Alabama at Birmingham (UAB) Hospital

    Birmingham, Alabama, 35233

  • Christie Clinic Vein and Vascular Center

    Champaign, Illinois, 61822

  • University Surgical Associates

    Chattanooga, Tennessee, 37404

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • Florida Research Network

    Gainesville, Florida, 32605

  • University of Iowa Hospitals and Clinics

    Iowa City, Iowa, 52242

  • The Mount Sinai Hospital

    New York, New York, 10029

  • Sentara Vascular Specialists

    Norfolk, Virginia, 23507

  • Richmond Vascular Center

    North Chesterfield, Virginia, 23236

  • Dialysis Access Institute

    Orangeburg, South Carolina, 29118

  • Coastal Vascular and Interventional

    Pensacola, Florida, 32504

  • Dallas Nephrology Associates

    Plano, Texas, 75093

  • North Carolina Nephrology PA

    Raleigh, North Carolina, 27610

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Capital Nephrology Medical Group

    Sacramento, California, 95825

  • Sanford University of South Dakota Medical Center

    Sioux Falls, South Dakota, 57105

  • Holy Name Medical Center

    Teaneck, New Jersey, 07666

  • SKI Vascular Center

    Tempe, Arizona, 85281

  • Vascular Institute of Virginia

    Woodbridge, Virginia, 22193

Other trials in United States

Japan6 sites
  • Kansai Rosai Hospital

    Amagasaki

  • Shonan Kamakura General Hospital

    Kamakura

  • Kishiwada Tokushukai Hospital

    Kishiwada

  • Saitama Medical Center Saitama Medical University

    Saitama

  • Shizuoka General Hospital

    Shizuoka

  • Tokyo Women's Medical University Hospital

    Tokyo

Other trials in Japan

New Zealand2 sites
  • Auckland City Hospital

    Auckland

  • Capital and Coast District Health Board

    Wellington

Other trials in New Zealand

About this study

Official title: Randomized Study of IN.PACT™ AV Access Paclitaxel-Coated Percutaneous Transluminal Angioplasty (PTA) Balloon vs. Standard PTA for the Treatment of Obstructive Lesions in the Native Arteriovenous Dialysis Fistulae (AVF)

To evaluate the safety and efficacy of the IN.PACT™ AV Access Drug Coated Balloon (DCB) compared to percutaneous transluminal angioplasty (PTA) for treatment of subjects presenting with de novo or non-stented restenotic obstructive lesion of native arteriovenous dialysis fistulae (AVF) in the upper extremity.

Read the detailed description

This is a prospective, global, multi-center, single-blinded, 1:1 randomized clinical trial evaluating the IN.PACT™ AV Access Drug Coated Balloon (DCB) compared to percutaneous transluminal angioplasty (PTA) for treatment of subjects presenting with de novo or non-stented restenotic obstructive lesion of native arteriovenous dialysis fistulae (AVF) in the upper extremity. The trial will be conducted in up to 30 sites in the United States, Japan, and New Zealand.

Being tested
IN.PACT AV DCB, Standard Balloon Angioplasty
Medical subject headings
Arteriovenous Fistula, Fistula

What participants receive

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

  • IN.PACT AV DCBDevice

    IN.PACT™ AV Paclitaxel-Coated Percutaneous Transluminal Angioplasty (PTA) Balloon

  • Standard Balloon AngioplastyDevice

    Standard PTA Balloon

Study groups in NCT03041467
Study groupRoleWhat they receive
IN.PACT AV DCBExperimentalPTA will be performed using the IN.PACT AV Access Drug Coated Balloon. IN.PACT AV Access DCB was the device name used during the clinical study. Medtronic has changed the name of the device to IN.PACT™ AV Paclitaxel-Coated Balloon Catheter (also referred as IN.PACT AV DCB). Hence, throughout posting, the study device will be referred to as the "IN.PACT AV DCB."
Receives: Device: IN.PACT AV DCB
Standard Balloon AngioplastyActive comparatorPTA will be performed using a commercially available uncoated PTA balloon.
Receives: Device: Standard Balloon Angioplasty

What is being measured

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

  1. Target Lesion Primary Patency Rate Through 6 Months

    Freedom from clinically-driven target lesion revascularization (CD-TLR) or access circuit thrombosis measured through 6 months post-procedure.

    Measured: 6 Months Post-Procedure

  2. Primary Safety Endpoint - Serious Adverse Event Rate

    Serious Adverse Event (SAE) rate involving the AV access circuit

    Measured: 30 days post procedure

Secondary outcomes (17)
  1. Access Circuit Primary Patency

    Defined as freedom from re-intervention in the access circuit or access circuit thrombosis through 3 months, 6 months, 9 months,12 months, 18 months, and 24 months post-procedure.

    Measured: 3, 6, 9, 12, 18, and 24 Months

  2. Target Lesion Primary Patency

    Percentage of participants with freedom from clinically driven target lesion revascularization or access thrombosis occurring in the target lesion through 3 months, 9 months,12 months, 18 months, and 24 months post-procedure.

    Measured: 3, 9, 12, 18, and 24 Months

  3. Cumulative Target Lesion Revascularizations

    The number and percentage of participants with target lesion revascularizations through 3 months, 6 months, 9 months,12 months, 18 months, and 24 months post-procedure.

    Measured: 3, 6, 9,12, 18, and 24 Months

  4. Total Number of Interventions Required to Maintain Target Lesion Patency

    The number of target lesion revascularizations per treatment arm through 3 months, 6 months, 9 months, 12 months,18 months, and 24 months post-procedure.

    Measured: 3, 6, 9, 12, 18, and 24 Months

  5. Total Number of Interventions Required to Maintain Access Circuit Patency

    The number of re-interventions in the target lesion and/or access circuit through 3 months, 6 months, 9 months,12 months, 18 months, and 24 months.

    Measured: 3, 6, 9, 12, 18, and 24 Months

  6. Cumulative Access Circuit Thromboses

    The number and percentage of participants with access circuit thrombosis through 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months.

    Measured: 3, 6, 9, 12, 18, and 24 Months

  7. Device Success

    Device Success is defined as successful delivery, inflation, deflation and retrieval of the intact study balloon device without burst at or below rated burst pressure (RBP) during the index procedure.

    Measured: Time of Procedure

  8. Procedure Success

    Maintenance of patency (≤30% residual stenosis) in the absence of peri-procedural serious adverse device effect (SADE).

    Measured: Time of Procedure

  9. Clinical Success

    Resumption of successful dialysis for at least one session after index procedure.

    Measured: From the time of the index procedure to the first successful dialysis session after index procedure. Typically, this is within 1 week of index procedure.

  10. Rate of Device Related Adverse Events

    Device Related Adverse Event Rate: defined as the number and percentage of participants with device related Adverse Events through 30 days, 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months.

    Measured: 30 days, 3, 6, 9, 12, 18, and 24 Months.

  11. Procedure Related Adverse Event Rate

    Procedure Related Adverse Event Rate: defined as the number and percentage of participants with procedure related Adverse Events reported post-index procedure until the first successful dialysis session through 30 days, 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months.

    Measured: 30 Days, 3, 6, 9, 12, 18, and 24 Months

  12. Target Lesion Revascularizations (TLR)

    Defined as the percentage of participants who had an event, the Kaplan-Meier method was used to estimate Cumulative Incidence up to 36 months post-index procedure.

    Measured: 6, 9, 12, 18, 24, and 36 Months

  13. Clinically-Driven Target Lesion Revascularizations (CD-TLR)

    Defined as the percentage of participants who had an event, the Kaplan-Meier method was used to estimate Cumulative Incidence with CD-TLR up to 36 months post index procedure

    Measured: 6, 9, 12, 18, 24, and 36 Months

  14. Re-interventions in the Access Circuit

    Defined as the percentage of participants who had a reinterventions occurring within the access circuit. The Kaplan-Meier method was used to estimate Cumulative Incidence up to 36 months post-index procedure.

    Measured: 6, 9, 12, 18, 24, and 36 Months

  15. Abandonment of Target AVF

    Defined as number of participants with abandonment of the target AV up to 36 months post-index procedure.

    Measured: 6, 9, 12, 18, 24, and 36 Months

  16. Serious Adverse Event Rate

    Serious Adverse Event Rate: defined as the number and percentage of participants with one or more Serious Adverse Events reported post-index procedure through 6 months, 12 months, 24 months, and 36 months.

    Measured: 6, 12, 24, and 36 Months

  17. Rate of Freedom From All-Cause Mortality Post Vital Status Update

    Percentage of participants who had all-cause death post vital status update. The Kaplan-Meier method was used to estimate survival probability up to 60 months post-index procedure through 6 months, 12 months, 24 months, 36 months, 48 months, and 60 months.

    Measured: 6, 12, 24, 36, 48, and 60 Months

Timeline

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

  1. First posted2 Feb 2017 (estimated)
  2. Study start25 Apr 2017
  3. Primary completion6 Dec 2018
  4. Study completion5 May 2023

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
Single blind
Who is masked
Participant
Enrolment
330 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03041467
Sponsor's protocol ID
APV-IN.PACT AV Access
Status last verified
Jun 2023
First submitted
1 Feb 2017
Last updated
29 May 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Holden A, Haruguchi H, Suemitsu K, Isogai N, Hull J, Wiechmann BN, Wang H, Seamans J, Lookstein R; on behalf IN.PACT AV Access Investigators. IN.PACT AV Access randomized trial update: 3-year clinical results by anatomic and demographic subsets and 5-year extension mortality analysis. CVIR Endovasc. 2026 Aug 19;9(1):105. doi: 10.1186/s42155-026-00746-z.

    PubMed 42616238
  • Holden A, Haruguchi H, Suemitsu K, Isogai N, Hull J, Wiechmann BN, Wang H, Wall B, Lookstein R; IN.PACT AV Access Investigators. Vessel and balloon sizing in the IN.PACT AV access trial: post-hoc analysis of procedural characteristics and outcomes. CVIR Endovasc. 2026 Feb 14;9(1):17. doi: 10.1186/s42155-026-00650-6.

    PubMed 41689689
  • Lookstein RA, Haruguchi H, Ouriel K, Weinberg I, Lei L, Cihlar S, Holden A; IN.PACT AV Access Investigators. Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas. N Engl J Med. 2020 Aug 20;383(8):733-742. doi: 10.1056/NEJMoa1914617.

    PubMed 32813949

Questions about this trial

What is this clinical trial studying?

A study testing IN.PACT AV DCB and Standard Balloon Angioplasty in people with Arteriovenous Fistula Stenosis and Arteriovenous Fistula Occlusion, run by Medtronic Endovascular at 29 sites in 3 countries.

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

Who may be eligible to take part?

The sponsor lists 10 inclusion and 21 exclusion criteria. 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 29 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States, Japan, New Zealand. 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 27 Feb 2020). 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?

Target Lesion Primary Patency Rate Through 6 Months (time frame: 6 Months Post-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 NCT03041467, which also lists 3 linked publications.

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 29 May 2024.

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