Comparison of Bovine Carotid Artery and Expanded Polytetrafluoroethylene (ePTFE) for Permanent Hemodialysis Access
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Purpose
The investigators did a randomized control trial comparing bovine carotid artery grafts with ePTFE grafts for patients that need hemodialysis access. The goal of the study was to determine differences in primary and assisted patency rates and frequency of complications between these two types of grafts. The investigators' hypothesis was that bovine carotid artery grafts more closely mimic autologous tissue and therefore, would provide better patency and fewer complications.
| Condition | Intervention |
|---|---|
|
Kidney Failure Renal Dialysis |
Procedure: Grafts placement |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Bovine Carotid Artery Graft Revisited: A Prospective, Randomized Comparison of Bovine Carotid Artery and Expanded Polytetrafluoroethylene for Permanent Hemodialysis Access |
- Primary and Assisted Patency [ Time Frame: 6, 12, 18, 24 months ] [ Designated as safety issue: No ]
- patients were monitored for the following complications: thrombosis of the graft; graft infection; pseudoaneurysm formation; steal syndrome. [ Time Frame: 6,12,18 and 24 months ] [ Designated as safety issue: No ]
| Enrollment: | 57 |
| Study Start Date: | April 2006 |
| Study Completion Date: | June 2009 |
| Primary Completion Date: | February 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Bovine Carotid Artery Graft |
Procedure: Grafts placement
Graft placement (upper or lower extremity); surgical or radiographic revision as needed.
Other Name: Artegraft
|
| Active Comparator: Expanded Polytetrafluoroethylene Grafts |
Procedure: Grafts placement
Graft placement (upper or lower extremity); surgical or radiographic revision as needed.
Other Name: Artegraft
|
Detailed Description:
Objective: To understand how bovine carotid artery (BCA) grafts compare to cuffed polytetrafluoroethylene (ePTFE) grafts as conduits for hemodialysis access in terms of patency and complications.
Background: Many hemodialysis patients do not have adequate anatomy for native arteriovenous fistulas. In these patients, synthetic conduits remain the only option for permanent hemodialysis access. We sought to compare the standard cuffed ePTFE with bovine carotid artery grafts as this has not been undertaken since the 1970's.
Methods: Following Institutional Review Board approval, a prospective, randomized controlled trial was conducted enrolling 29 patients in the BCA group and 28 patients in the ePTFE group. Univariate and multivariate analysis was undertaken to understand factors that affect complications. Patency rates were calculated using the Kaplan-Meyer method.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Chronic kidney disease stage 4 or 5, in need of hemodialysis access
Exclusion Criteria:
- Surgically suitable for a native arteriovenous fistula
Contacts and Locations| United States, Massachusetts | |
| Massachusetts General Hospital | |
| Boston, Massachusetts, United States, 02114 | |
| Principal Investigator: | Tatsuo Kawai, MD, PhD | Massachusetts General Hospital |
More Information
No publications provided
| Responsible Party: | Tatsuo Kawai, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT01021839 History of Changes |
| Other Study ID Numbers: | 2006p-000081 |
| Study First Received: | November 18, 2009 |
| Last Updated: | November 25, 2009 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Massachusetts General Hospital:
|
renal dialysis bioprosthesis arteriovenous shunt surgical |
Additional relevant MeSH terms:
|
Renal Insufficiency Kidney Diseases Urologic Diseases |
ClinicalTrials.gov processed this record on June 18, 2013