Trial Outcomes & Findings for Post-Approval Study for the FLAIR Endovascular Stent Graft (NCT NCT00677235)

NCT ID: NCT00677235

Last Updated: 2017-03-10

Results Overview

To demonstrate that the post intervention Access Circuit Primary Patency (ACPP) of FLAIR™ is superior to that of PTA at 12 months post study procedure.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

270 participants

Primary outcome timeframe

12 months

Results posted on

2017-03-10

Participant Flow

Participant milestones

Participant milestones
Measure
FLAIR
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
Percutaneous Transluminal Angioplasty (PTA): Treatment of stenoses with PTA only
Overall Study
STARTED
138
132
Overall Study
COMPLETED
97
94
Overall Study
NOT COMPLETED
41
38

Reasons for withdrawal

Reasons for withdrawal
Measure
FLAIR
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
Percutaneous Transluminal Angioplasty (PTA): Treatment of stenoses with PTA only
Overall Study
Withdrawal by Subject
1
1
Overall Study
Lost to Follow-up
2
1
Overall Study
Death
37
36
Overall Study
Adverse Experience
1
0

Baseline Characteristics

Post-Approval Study for the FLAIR Endovascular Stent Graft

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Total
n=270 Participants
Total of all reporting groups
Age, Continuous
64 years
n=99 Participants
63 years
n=107 Participants
63.5 years
n=206 Participants
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
65 Participants
n=99 Participants
69 Participants
n=107 Participants
134 Participants
n=206 Participants
Age, Categorical
>=65 years
73 Participants
n=99 Participants
63 Participants
n=107 Participants
136 Participants
n=206 Participants
Sex: Female, Male
Female
87 Participants
n=99 Participants
86 Participants
n=107 Participants
173 Participants
n=206 Participants
Sex: Female, Male
Male
51 Participants
n=99 Participants
46 Participants
n=107 Participants
97 Participants
n=206 Participants
Region of Enrollment
United States
138 participants
n=99 Participants
132 participants
n=107 Participants
270 participants
n=206 Participants

PRIMARY outcome

Timeframe: 12 months

Population: All patients who were enrolled in the study were included in the analysis in the treatment group to which they were randomized, regardless of the intervention that they actually incurred (an intent-to-treat analysis).

To demonstrate that the post intervention Access Circuit Primary Patency (ACPP) of FLAIR™ is superior to that of PTA at 12 months post study procedure.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
ACPP Was Defined as the Interval Following the Index Procedure Until the Next Access Thrombosis or Reintervention.
0.240 proportion of participants
Interval 0.165 to 0.315
0.110 proportion of participants
Interval 0.054 to 0.167

PRIMARY outcome

Timeframe: 12 months

Population: All patients who were enrolled in the study will participate in the analysis in the treatment group to which they were randomized, regardless of the intervention that they actually incurred (an intent-to-treat analysis).Blackwelder t-test testing non-inferiority of the FLAIR® group to that of PTA.

The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the arteriovenous (AV) access circuit in order to maintain vascular access for hemodialysis.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
The Index of Patency Function (IPF) [the Average Number of Months Between Interventions] of FLAIR™ is Not Inferior to That of PTA at 12 Months Post Study Procedure.
5.2 Months/intervention
Standard Deviation 4.08
4.4 Months/intervention
Standard Deviation 3.51

PRIMARY outcome

Timeframe: 12 months

Outcome measures

Outcome measures
Measure
FLAIR
n=128 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=130 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
The Number of Participants With Device and/or Procedure Related Adverse Events at 12 Months Post Study Procedure.
128 Number of Participants with Device and/o
130 Number of Participants with Device and/o

SECONDARY outcome

Timeframe: Patient Follow-Up

The estimated number of re-interventions to the access circuit until graft abandonment or through 12 months post-index procedure was a secondary endpoint without hypothesis testing and is therefore summarized descriptively.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
To Assess the Number of Re-interventions to the Access Circuit Until Graft Abandonment or Through 12 Months Post-index Procedure
1.9 reinterventions
Standard Deviation 2.18
2.4 reinterventions
Standard Deviation 2.31

SECONDARY outcome

Timeframe: 12 months

Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-Intervention Assisted Primary Patency at 12 Months
0.497 proportion of participants
Interval 0.41 to 0.584
0.563 proportion of participants
Interval 0.474 to 0.653

SECONDARY outcome

Timeframe: 12 months

Postintervention secondary patency \[PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial\] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-intervention Secondary Patency (PSP) at 12 Months
0.653 proportion of participants
Interval 0.569 to 0.736
0.710 proportion of participants
Interval 0.629 to 0.792

SECONDARY outcome

Timeframe: Patient Follow-Up

Procedural success was a secondary endpoint without hypothesis testing and is therefore summarized descriptively. Procedural success is defined as anatomic success and at least one indicator of hemodynamic or clinical success.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Procedural Success
81.2 Percentage of Participants
75.0 Percentage of Participants

SECONDARY outcome

Timeframe: Patient Follow-Up

The incidence of device-related and procedure-related serious adverse events (SAEs) from the index procedure through 30 days post procedure is summarized. The purpose of this analysis was to assess the effectiveness of the Bard Peripheral Vascular (BPV) clinician training program.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Analysis of Proportion of Serious Adverse Events Classified as Device and/or Procedure-Related Through 30 Days Post-Procedure
2 events
0 events

SECONDARY outcome

Timeframe: 12 months

Serious Adverse Events at 12 months are reported for all 270 subjects.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Demonstrate Non-inferiority of FLAIR Safety in Terms of Serious Adverse Events at 12 Months
60.9 percentage of participants with serious
65.9 percentage of participants with serious

SECONDARY outcome

Timeframe: 24 months

Population: All patients who were enrolled in the study were included in the analysis in the treatment group to which they were randomized, regardless of the intervention that they actually incurred (an intent-to-treat analysis).

Access Circuit Primary Patency (ACPP) was defined as the interval following the index procedure until the next access thrombosis or reintervention at 24 months.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Access Circuit Primary Patency (ACCP) at 24 Months Procedure Until the Next Access Thrombosis or Reintervention.
0.095 proportion of participants
Interval 0.029 to 0.162
0.055 proportion of participants
Interval 0.013 to 0.097

SECONDARY outcome

Timeframe: 24 months

To estimate the percentage of participants without safety issues through 24 months.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
To Estimate Safety at 24 Months.
10.9 percentage of participants
3 percentage of participants

SECONDARY outcome

Timeframe: 24 month follow up

Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-Intervention Assisted Primary Patency at 24 Months
0.384 proportion of participants
Interval 0.282 to 0.486
0.406 proportion of participants
Interval 0.312 to 0.5

SECONDARY outcome

Timeframe: 24 months

Postintervention secondary patency \[PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial\] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-intervention Secondary Patency at 24 Months
0.518 proportion of participants
Interval 0.41 to 0.626
0.574 proportion of participants
Interval 0.481 to 0.668

SECONDARY outcome

Timeframe: 24 months

Population: All patients who were enrolled in the study will participate in the analysis in the treatment group to which they were randomized, regardless of the intervention that they actually incurred (an intent-to-treat analysis).Blackwelder t-test testing non-inferiority of the FLAIR® group to that of PTA.

The IPF is summarized was defined as the time from the index study procedure to complete graft abandonment divided by the number of visits for a reintervention performed on the AV access circuit in order to maintain vascular access for hemodialysis.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Index of Patency Function (IPF) [the Average Number of Months Between Interventions] Rates of FLAIR™ and PTA at at 24 Months.
7.1 Months/intervention
Standard Deviation 7.04
5.3 Months/intervention
Standard Deviation 5.22

SECONDARY outcome

Timeframe: 6 month follow up

Postintervention assisted primary patency (PAPP) was defined as the interval after the index/study procedure until access thrombosis or a surgical intervention that excluded the treated lesion from the access circuit.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-Intervention Assisted Primary Patency at 6 Months
0.596 proportion of participants
Interval 0.512 to 0.681
0.656 proportion of participants
Interval 0.573 to 0.74

SECONDARY outcome

Timeframe: 6 month follow-up

Postintervention secondary patency \[PSP; referred to as Access Circuit Cumulative Patency (ACCP) in the pivotal trial\] was the interval following the treatment procedure until the access circuit was surgically declotted, revised, or abandoned because of inability to treat the original stenosis.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Post-intervention Secondary Patency at 6 Months
0.748 proportion of participants
Interval 0.673 to 0.822
0.793 proportion of participants
Interval 0.722 to 0.864

POST_HOC outcome

Timeframe: 12 months follow up

TAPP is defined as patency (open to blood flow) after the study index procedure until reintervention in the treatment area (within 5mm proximal or 5mm distal to the study device or index balloon angioplasty treated area), or thrombotic occlusion that involved the treatment area.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Treatment Area Primary Patency (TAPP) at 12 Months.
0.476 proportion of participants
Interval 0.389 to 0.564
0.248 proportion of participants
Interval 0.17 to 0.325

POST_HOC outcome

Timeframe: 24 months follow-up

TAPP is defined as patency (open to blood flow) after the study index procedure until reintervention in the treatment area (within 5mm proximal or 5mm distal to the study device or index balloon angioplasty treated area), or thrombotic occlusion that involved the treatment area.

Outcome measures

Outcome measures
Measure
FLAIR
n=138 Participants
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 Participants
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Treatment Area Primary Patency (TAPP) at 24 Months.
0.269 proportion of participants
Interval 0.177 to 0.36
0.135 proportion of participants
Interval 0.068 to 0.202

Adverse Events

FLAIR

Serious events: 84 serious events
Other events: 128 other events
Deaths: 0 deaths

PTA Only

Serious events: 87 serious events
Other events: 127 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
FLAIR
n=138 participants at risk
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 participants at risk
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Cardiac disorders
Cerebrovascular accident
1.4%
2/138 • Number of events 2 • From Index Procedure through 24 months of follow-up.
3.8%
5/132 • Number of events 5 • From Index Procedure through 24 months of follow-up.
Cardiac disorders
Congestive heart failure
3.6%
5/138 • Number of events 5 • From Index Procedure through 24 months of follow-up.
3.8%
5/132 • Number of events 5 • From Index Procedure through 24 months of follow-up.
Blood and lymphatic system disorders
hemotoma
1.4%
2/138 • Number of events 2 • From Index Procedure through 24 months of follow-up.
0.00%
0/132 • From Index Procedure through 24 months of follow-up.
Blood and lymphatic system disorders
Hemorrhage
4.3%
6/138 • Number of events 6 • From Index Procedure through 24 months of follow-up.
5.3%
7/132 • Number of events 7 • From Index Procedure through 24 months of follow-up.
Infections and infestations
Infection
23.2%
32/138 • Number of events 32 • From Index Procedure through 24 months of follow-up.
25.0%
33/132 • Number of events 33 • From Index Procedure through 24 months of follow-up.
Injury, poisoning and procedural complications
Pain
2.9%
4/138 • Number of events 4 • From Index Procedure through 24 months of follow-up.
1.5%
2/132 • Number of events 2 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Pseudoaneurysm
1.4%
2/138 • Number of events 2 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Significant arm or hand edema
0.00%
0/138 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Stenosis requiring intervention
3.6%
5/138 • Number of events 5 • From Index Procedure through 24 months of follow-up.
4.5%
6/132 • Number of events 6 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Thrombotic occlusion
9.4%
13/138 • Number of events 13 • From Index Procedure through 24 months of follow-up.
2.3%
3/132 • Number of events 3 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Other
50.0%
69/138 • Number of events 69 • From Index Procedure through 24 months of follow-up.
52.3%
69/132 • Number of events 69 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Perforation
0.72%
1/138 • Number of events 1 • From Index Procedure through 24 months of follow-up.
0.00%
0/132 • From Index Procedure through 24 months of follow-up.

Other adverse events

Other adverse events
Measure
FLAIR
n=138 participants at risk
FLAIR Endovascular Stent Graft FLAIR Endovascular Stent Graft: Treatment of stenoses with primary PTA and placement of the FLAIR Endovascular Stent Graft
PTA Only
n=132 participants at risk
Percutaneous Transluminal Angioplasty PTA: Treatment of stenoses with PTA only
Vascular disorders
Cerebrovascular Accident
0.00%
0/138 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Congestive heart failure
2.9%
4/138 • Number of events 4 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Embolism
0.72%
1/138 • Number of events 1 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Hematoma
2.2%
3/138 • Number of events 3 • From Index Procedure through 24 months of follow-up.
0.76%
1/132 • Number of events 1 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Hemorrhage
6.5%
9/138 • Number of events 9 • From Index Procedure through 24 months of follow-up.
6.1%
8/132 • Number of events 8 • From Index Procedure through 24 months of follow-up.
Infections and infestations
Infection
7.2%
10/138 • Number of events 10 • From Index Procedure through 24 months of follow-up.
3.0%
4/132 • Number of events 4 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Pseudoaneurysm
5.1%
7/138 • Number of events 7 • From Index Procedure through 24 months of follow-up.
11.4%
15/132 • Number of events 15 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Significant arm or hand edema
2.2%
3/138 • Number of events 3 • From Index Procedure through 24 months of follow-up.
1.5%
2/132 • Number of events 2 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Steal syndrome
4.3%
6/138 • Number of events 6 • From Index Procedure through 24 months of follow-up.
2.3%
3/132 • Number of events 3 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Stenosis requiring intervention
59.4%
82/138 • Number of events 82 • From Index Procedure through 24 months of follow-up.
78.0%
103/132 • Number of events 103 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Thrombotic occlusion
34.1%
47/138 • Number of events 47 • From Index Procedure through 24 months of follow-up.
34.1%
45/132 • Number of events 45 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Vessel rupture
1.4%
2/138 • Number of events 2 • From Index Procedure through 24 months of follow-up.
1.5%
2/132 • Number of events 2 • From Index Procedure through 24 months of follow-up.
Vascular disorders
Other
9.4%
13/138 • Number of events 13 • From Index Procedure through 24 months of follow-up.
10.6%
14/132 • Number of events 14 • From Index Procedure through 24 months of follow-up.

Additional Information

John Van Vleet

Bard Peripheral Vascular

Phone: 1-800-321-4254

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60