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NCT06190717ClinicalTrials.gov

Maturation of Arteriovenous Fistula With Automated Sonography Assessments Trial

En recrutementAccepte des participants actuellement, selon la fiche du registre.
Contacter cette étude

En bref

This is a prospective, multi-center, two-arm, randomized trial to quantify the performance of the EchoMark®/EchoSure® System for AVF diagnostic ultrasound when used under a protocol of biweekly use for assessing fistula maturation and reducing time to Clinical Maturation.

Interventionnelle304 participants recherchés21 sites1 pays

Catégories

Enregistré dans 1 registre

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Les informations de l'essai sont affichées telles que publiées par le registre, dans leur langue d'origine.

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

  • Present: Registered before enrolment beganFirst posted 2024-01-05; recorded start 2024-02-21
  • Present: Has a defined primary outcomeA primary outcome measure is listed in the record
  • Present: The primary outcome states a time frameThe primary outcome measure records a time frame
  • Present: Participants are randomly assignedAllocation is recorded as randomised
  • Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
  • Not stated: Open label (no blinding)Masking is recorded as none (open label)
  • Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
  • Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
  • Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
  • Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
  • Not stated: No other studies from this sponsor are in this databaseCounted from the lead sponsor named in the record (Sonavex, Inc.)
  • Not stated: No posted results from this sponsor are in this database yetBased on the sponsor’s studies in this database
  • The record lists 2 conditions.
  • Lead sponsor type recorded as: industry.

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourSTRONG

A strong methodological design for a study of this type, judged from its ClinicalTrials.gov record.

How this score is built
  • Randomised allocation20/20

    Participants are randomly allocated between arms

  • Blinding0/20

    Open-label

  • Control arm15/15

    Active-comparator control arm

  • Primary-outcome specificity10/10

    Named primary outcome with a defined time frame

  • Endpoint type3/10

    Surrogate or intermediate endpoint (conservative default)

  • Multi-centre8/8

    Multi-centre: 21 sites

  • Data monitoring committee7/7

    A data monitoring committee is in place

  • Prospective registration5/5

    Registered before the study start date

  • Protocol / SAP posted0/5

    No protocol or SAP posted to the registry

ScaleMEDIUM

A medium-sized study: 304 participants (target), run at 21 sites.

How this score is built
  • Enrolment24/40

    304 participants (target)

  • Site count16/25

    21 sites

  • Country count0/15

    Single country

  • Planned duration8/10

    Planned over about 36 months

  • Sponsor scale0/10

    Sonavex, Inc. has led 1 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built
  • Investigator standing0/100

    No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Résumé

This is a prospective, multi-center, two-arm, randomized trial to quantify the performance of the EchoMark®/EchoSure® System for AVF diagnostic ultrasound when used under a protocol of biweekly use for assessing fistula maturation and reducing time to Clinical Maturation.

Affections

  • End Stage Renal Disease
  • Diabetes

Éligibilité

Éligibilité
SexeTous
Âges18 Years84 Years
Volontaires sainsNon

Éligibilité telle qu'elle figure dans le registre

Inclusion Criteria: * Males or non-pregnant, non-breastfeeding females ≥ 18 years of age but \< 85 years of age at the time of informed consent. * Subject is able and willing to provide written informed consent prior to receiving any non-standard of care, protocol specific procedures. * Subject is willing and capable of complying with all required follow-up visits. * Subject and/or Care Team agree that the distance and transportation resources from the patient's home to the clinic are reasonable for study participation and compliance. * Subject has an estimated life expectancy \> 18 months. * Subject is ambulatory (cane or walker are acceptable). * CKD Stage 5 (eGFR less than 10) or ESRD subjects presenting for upper arm autologous arteriovenous fistula creation that is not transposed for hemodialysis access. * Subjects who are currently on dialysis through a CVC or who imminently require dialysis (GFR \<10). * Vein diameter ≥ 2.5 mm at the antecubital fossa per vein mapping. * Artery diameter ≥ 2.5 mm per vein mapping. * Subject is not participating in another investigational clinical trial that has not met its primary end point. Participation in post-market registry is acceptable. Exclusion Criteria: * CKD Stage 1-4 or subjects that do not require upper arm autologous arteriovenous fistula creation for hemodialysis access. * Subject has history of Steal Syndrome. * Subject who is immunocompromised or immunosuppressed. * Subject has had three previous failed AV fistulae for hemodialysis access. * Subjects expecting to undergo major surgery within 60 days from the EchoMark implantation. * Known or suspected active infection on the day of the index procedure. * Subjects who had infection(s) in the 30-day window prior to EchoMark placement to reduce the likelihood of partially treated infections that can seed the device and fistula. * Subjects with diagnosed bleeding disorder, thrombocytopenia (platelet count \<50,000), hypercoagulability, and history of recurrent deep vein thrombosis not related to AV access. * Subjects with active malignancy. * Subjects with a history of poor compliance with the dialysis protocol. * Subjects with a known or suspected allergy to any of the device materials. * Subjects with an existing fistula or graft. * Subjects who are anticipated to convert to peritoneal dialysis or undergo a transplant within 6 months. * Subjects who are pregnant, planning on becoming pregnant, or are breast feeding.

Éligibilité en énoncés simples

Les critères de cette fiche n'ont pas encore été décomposés en énoncés distincts. Le texte du registre ci-dessus est complet et fait foi.

Conception de l'étude

Conception de l'étude
Type d'étudeInterventionnelle
PhaseSans objet
RépartitionRandomisée
Modèle d'interventionPARALLEL
Objectif principalTREATMENT
InsuNONE (0)
Recrutement304 participants recherchés

Promoteur et collaborateurs

  • Sonavex, Inc. Promoteur

Groupes et interventions

  • Diagnostic ArmEXPERIMENTAL

    All subjects will have the EchoMark implanted. Subjects will be assessed every 2 weeks (+/- 1 week) (but no more frequently than weekly) with the EchoSure system until fistula maturation occurs and/or permanent access use is achieved.

  • Standard of CareACTIVE_COMPARATOR

    Subjects will be evaluated per KDOQI guidelines (with physical examination at approximately 2 weeks (+/- 1 week) and between 4 and 6 weeks (+/- 1 week)). If evaluation yields abnormal findings, subjects will receive a Duplex ultrasound assessment (DUS). All SOC Arm subjects will be followed per the institution's standard of care until fistula maturation occurs and/or permanent access use is achieved but no more frequently than once per month.

Interventions

  • Dispositif EchoMark/EchoSure

    Subjects assigned to the Diagnostic Arm will have the EchoMark implanted at the time of AVF creation. The subject will return every 2 weeks for a follow-up assessment to include an EchoSure scan until fistula maturation and/or permanent access use is achieved. The EchoSure scans are to be reviewed by the investigator(s) or delegated study staff and aid in the determination when a further assessment, including a physical exam, is required to determine cannulation clearance or if an intervention(s) may be required to prevent failure of fistula maturation. All physical exams will include assessing the fistula for bruit and thrill. The subject's medical history will be reviewed at each visit and will include all interventions, cannulation attempts, and adverse event reporting.

  • Intervention Standard of Care

    Subjects are assessed using standard of care per KDOQI guidelines, which includes a physical exam at the 2-week follow-up visit and at the 4-6-week follow-up visit. All follow-up visits will include an assessment of adverse events and medical history review to include all interventions, cannulation attempts, and laboratory results. If evaluation yields an abnormal finding, subjects will undergo a Duplex ultrasound assessment and treatment under the institution's standard of care. All SOC Arm subjects will be followed per the institution's standard of care until fistula maturation occurs and/or permanent access use is achieved but no more frequently than once per month.

Critères de jugement

  1. Critère de jugement principal

    Primary Safety Endpoint

    Freedom from the following through 6 months as adjudicated by the CEC: 1. Clinically significant misplacement or migration of the EchoMark implant. 2. Vessel or tissue injury caused by the EchoMark implant procedure of the implant over time, requiring surgical intervention. 3. Infection of tissues surrounding the EchoMark implant requiring IV/ 4. Complication requiring explantation of the EchoMark implant.

    Délai 6 months

  2. Critère de jugement principal

    Primary Effectiveness Endpoint

    Time to clinical maturation

    Délai 6 months

  3. Critère de jugement secondaire

    Difference between EchoSure and Duplex Flow Measurements

    Difference between log10-transformed EchoSure and Duplex flow measurements of blood flow for assessment of measurement agreement in the diagnostic arm.

    Délai 6 Months

  4. Critère de jugement secondaire

    EchoSure Depth Comparison

    Difference between EchoSure and CoreLab measurements of depth for assessment of measurement agreement in the diagnostic arm.

    Délai 6 Months

  5. Critère de jugement secondaire

    EchoSure Diameter Comparison

    Difference between EchoSure and CoreLab measurement of diameter for assessment of measurement agreement in the diagnostic arm.

    Délai 6 Months

  6. Critère de jugement secondaire

    EchoMark/EchoSure System Technical Success

    Technical Success defined as the successful implantation of the EchoMark implant and the ability to complete each scan to determine the blood flow, diameter, and depth measurements at the EchoMark using the EchoSure diagnostic ultrasound system from baseline to Clinical Maturation, fistula failure, or 4 months, whichever is sooner.

    Délai 4 Months

  7. Critère de jugement secondaire

    CVC Removal

    Time to CVC removal by subject group

    Délai 6 Months

  8. Critère de jugement secondaire

    Rate of Hospitalization

    Rate of hospitalization(s) by subject group from baseline to Clinical Maturation.

    Délai 6 Months

  9. Critère de jugement secondaire

    AV Fistula Maturation Rate

    Percent of AVFs created that mature by 180 days by subject group.

    Délai 6 Months

  10. Critère de jugement secondaire

    Total Cost of Care

    Total cost of care, defined by National average Medicare payment rate (facility and professional fees) for procedures and care provided to subject by subject group from baseline to Clinical Maturation.

    Délai 6 Months

  11. Critère de jugement secondaire

    Freedom from Events through 30 and 90 Days

    Freedom from the following through 30 and 90 days from the baseline procedure as adjudicated by the CEC: 1. Clinically significant misplacement or migration of the EchoMark implant. 2. Vessel or tissue injury caused by the EchoMark implant procedure of the implant over time, requiring surgical intervention. 3. Infection of tissues surrounding the EchoMark implant requiring IV antibiotic treatment. 4. Complication requiring explantation of the EchoMark implant.

    Délai 30 Days and 90 Days

  12. Autre critère de jugement

    Hierarchical Composite 1

    Hierarchical composite of the DIAG arm and SOC arm comparing occurrences of: Fistula creation success.

    Délai 6 Months

  13. Autre critère de jugement

    Hierarchical Composite 2

    Hierarchical composite of the DIAG arm and SOC arm comparing occurrences of: Alive through 180 days.

    Délai 6 Months

  14. Autre critère de jugement

    Hierarchical Composite 3

    Hierarchical composite of the DIAG arm and SOC arm comparing occurrences of: Freedom from SAE with 180 days (severity as a tie-breaker for SAEs with matching adverse event term)

    Délai 6 Months

  15. Autre critère de jugement

    Hierarchical Composite 4

    Hierarchical composite of the DIAG arm and SOC arm comparing occurrences of: Earlier time to AV fistula Clinical Maturation with 180 days.

    Délai 6 Months

  16. Autre critère de jugement

    Comparison of Composite and Stratified MAE Rates

    Comparison of composite and stratified MAE rates for both subject groups at 6 months and end of study. MAEs are adjudicated by the CEC and defined as any of the following: 1. Clinically significant misplacement or migration of the EchoMark implant. 2. Vessel or tissue injury caused by the EchoMark implant procedure or the implant over time, requiring surgical intervention. 3. Complication requiring explantation of the EchoMark implant. 4. Clinically significant surgical complications (seroma, edema, hematoma, bleeding), excluding expected resorption response visible as hypoechoic region on B-mode ultrasound. 5. Infection requiring IV antibiotic treatment. Pseudoaneurysm. 6. Thrombosis of the AVF circuit that requires an intervention (surgical or endovascular). 7. Steal Syndrome.

    Délai 6 Months and 12 Months

  17. Autre critère de jugement

    Comparision of Implant and Procedure Related Adverse Events

    Comparison of all stratified implant and procedure related AE (as adjudicated by the CEC) rates between subject groups at 6 months and end of study.

    Délai 6 Months and 12 Months

  18. Autre critère de jugement

    Clinical Maturation

    Percent of subjects that have reached Clinical Maturation (as adjudicated by the CEC) for each subject group at 90 days, 120 day, 150 days, and 180 days.

    Délai 3 Months, 4 Months, 5 Months, and 6 Months

  19. Autre critère de jugement

    Cannulation Complication Rates

    Comparison of composite and stratified cannulation complication (as adjudicated by the CEC) rates between subject groups for the following AEs: 1. Infection due to cannulation. 2. Thrombosis due to hematoma. 3. Any other AE determined by the CEC to be cannulation related.

    Délai 12 Months

  20. Autre critère de jugement

    Time to Clinical Maturation for Procedure and Device Related Events

    Distribution of time to Clinical Maturation for both groups for each of the following procedure and device related categories presented as violin/box plots: 1. Clinically significant misplacement or migration of the EchoMark implant. 2. Vessel or tissue injury caused by the EchoMark implant procedure or the implant over time, requiring surgical intervention. 3. Clinically significant surgical complications (seroma, edema, hematoma, bleeding), excluding expected resorption response visible as hypoechoic region on B-mode ultrasound. 4. Infection requiring IV antibiotic treatment. 5. Pseudoaneurysm. 6. Thrombosis of AVF circuit requiring an intervention (surgical or endovascular). 7. Steal Syndrome. 8. No SAE.

    Délai 6 Months

  21. Autre critère de jugement

    Primary Functional Patency

    Primary functional patency at 6 months (as adjudicated by the CEC) defined as freedom from intervention on the AVF after maturation.

    Délai 6 Months

  22. Autre critère de jugement

    Secondary Function Patency

    Secondary functional patency at 6 months (as adjudicated by the CEC) is defined as freedom from abandonment of the AVF after maturation.

    Délai 6 Months

  23. Autre critère de jugement

    Time to Clinical Maturation

    Time to Clinical Maturation (as adjudicated by the CEC) defined as the time from initial fistula creation to Clinical Maturation.

    Délai 6 Months

  24. Autre critère de jugement

    Time to Clinical Maturation for Each Fistula

    Time to Clinical Maturation (as adjudicated by the CEC) for each new fistula defined as the time from new fistula creation to Clinical Maturation.

    Délai 6 Months

  25. Autre critère de jugement

    Technical Success Cannulation Scans

    Rate of cannulation zone technical success rate defined as the ability to complete each scan to determine the diameter, and depth measurements at the proximal, mid, and distal segments of the fistula using the EchoSure diagnostic ultrasound system from the 2-week follow-up to Clinical Maturation, or 4 months, whichever is sooner.

    Délai 4 Months

  26. Autre critère de jugement

    EchoSure Diameter and Depth Comparison in Cannulation Zone

    Agreement of EchoSure diameter and depth results from the cannulation zone at the 6-week follow-up compared to the CoreLab measured diameter and depth results in the DIAG arm.

    Délai 6 Months

  27. Autre critère de jugement

    Intervention to Assist Maturation Rate

    Surgical or Endovascular Interventions to Assist Maturation defined as the difference between groups in the proportion of subjects with surgical or endovascular interventions to assist maturation.

    Délai 6 Months

Dates

Dates
Date de début21 février 2024 (réelle)
Achèvement principal1 février 2027 (estimée)
Achèvement1 février 2027 (estimée)
Première publication5 janvier 2024 (réelle)
Dernière mise à jour13 avril 2026
Résultats publiésNon précisé dans la fiche du registre
Statut vérifié pour la dernière foisjuin 2025

Réelle signifie que l'événement a eu lieu. Estimée signifie que le promoteur s'y attend. Les deux ont un sens différent.

Lieux

20 sites sont en recrutement

United States

United States
ÉtablissementVilleÉtat ou régionStatut
HealthQare AssociatesArlingtonVirginiaEn recrutement
Boston Medical CenterBostonMassachusettsEn recrutement
Galen Medical GroupChattanoogaTennesseeEn recrutement
Northwestern UniversityChicagoIllinoisEn recrutement
Atrium HealthConcordNorth CarolinaEn recrutement
Baylor Scott & White Heart and Vascular HospitalDallasTexasEn recrutement
Trinity Research GroupDothanAlabamaEn recrutement
Prisma HealthGreenvilleSouth CarolinaEn recrutement
Aqua Research Institute LlcHoustonTexasEn recrutement
MSU Health Care Heart and VascularLansingMichiganEn recrutement
Fresenius Vascular Care Memphis MSOMemphisTennesseeArrêté prématurément
Northwell HealthNew Hyde ParkNew YorkEn recrutement
Medical University of South Carolina Health OrangeburgOrangeburgSouth CarolinaEn recrutement
Orlando Health Heart and Vascular InstituteOrlandoFloridaEn recrutement
Capital Medical CenterPenningtonNew JerseyEn recrutement
Southwest Kidney InstitutePhoenixArizonaEn recrutement
AKDHC Medical Research ServicesPhoenixArizonaEn recrutement
Physicians Care of VirginiaRoanokeVirginiaEn recrutement
AKDHC Center TucsonTucsonArizonaEn recrutement
Sentara HealthVirginia BeachVirginiaEn recrutement
Kansas Nephrology Research InstituteWichitaKansasEn recrutement

Documents de l'étude

Aucun document n'est lié dans cette fiche du registre.

Évolution au fil du temps

Aucun changement n'a été enregistré depuis que nous avons intégré cette fiche pour la première fois.

Un changement est enregistré chaque fois que le promoteur met à jour la fiche du registre. Le statut, les dates, le recrutement et les sites apparaissent ici au fur et à mesure de leur évolution.