VectorFlow Tunneled Dialysis Catheter (TDC) Versus Palindrome TDC

University of Pennsylvania100 enrolled

Overview

Randomized two-arm study examining 90 day primary patency of two FDA-approved tunneled dialysis catheters.

The VectorFlow tunneled dialysis catheter is a novel symmetrical tip design tunneled dialysis catheter which in pre-clinical testing and retrospective review has improved flow and patency compared to other dialysis catheter designs. This study will compare 90 day patency rates of newly inserted VF catheters to the Palindrome catheter both of which are FDA approved devices and will inserted as standard of care. The Palindrome catheter has been selected as the comparison device because it is also a symmetrical tip catheter design and prior studies by the manufacturer of this device suggests it has a lower occlusion rate and better flow compared to other catheter designs.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

100

Conditions

Renal Failure Chronic Requiring Hemodialysis Chronic Renal Insufficiency

Interventions

VectorFlow TDCDEVICE

TDC insertion with VectorFlow will be in accordance with its FDA-approved indication under moderate sedation or general anesthesia with local anesthesia using 1% lidocaine in per institutional protocol. Following TDC insertion, the catheter may be used immediately. The goal of HD is typically to achieve a target effective blood flow of 300mL/min within the first 3 hemodialysis sessions. The dialysis records from each of the first three HD sessions will be reviewed by the study coordinator for (A) Blood flow rate (QB), (B) Arterial and venous lumen pressures, (C) Kt/V, and (D) Urea reduction ratio (URR). Additionally, need and use of thrombolytic infusion (ie t-PA) (other than single dose injection) to restore or improve patency and/or need for catheter exchange.

Palindrome TDCDEVICE

TDC insertion with Palindrome will be in accordance with its FDA-approved indication under moderate sedation or general anesthesia with local anesthesia using 1% lidocaine in per institutional protocol. Following TDC insertion, the catheter may be used immediately. The goal of HD is typically to achieve a target effective blood flow of 300mL/min within the first 3 hemodialysis sessions. The dialysis records from each of the first three HD sessions will be reviewed by the study coordinator for (A) Blood flow rate (QB), (B) Arterial and venous lumen pressures, (C) Kt/V, and (D) Urea reduction ratio (URR). Additionally, need and use of thrombolytic infusion (ie t-PA) (other than single dose injection) to restore or improve patency and/or need for catheter exchange.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * End stage renal disease or acute renal failure requiring hemodialysis through a tunneled dialysis catheter * Age \>18, Age \<80 * Capable of giving informed consent Exclusion Criteria: * Coagulopathy defined as international normalized ration (INR) \>2 which cannot be corrected with fresh frozen plasma * Platelet count \<50,000/microliter, which cannot be corrected with platelet transfusion * Active skin infections at site of TDC insertion * Presence of bacteremia or infected AVG/AVF within 7 days prior to enrollment * Neutropenia defined as absolute neutrophil count less then 1,700/microliter * Known central venous stenosis * Occlusion of bilateral external and internal jugular veins or bilateral brachiocephalic veins or stenosis of the superior vena cava * Functioning surgical HD access (ie AVG/AVF) or AVG/AVF which is expected to be functional within 90 days of enrollment * Inability to provide informed consent * Pregnant or nursing women * In the event a physician does not feel that either catheter would be appropriate for a subject, the subject will not be eligible to participate

Locations (2)

Hospital of the Unviersity of Pennsylvania

Philadelphia, Pennsylvania, United States

Penn Presbyterian Medical Center

Philadelphia, Pennsylvania, United States

Outcomes

Primary Outcomes

Primary Patency - Intervention-free Interval (Measured in Weeks)

The primary study endpoint will be primary patency at 90 days following catheter insertion. Primary patency is defined as an HD catheter which provides adequate hemodialysis (flow \>300mL/min) without need for additional interventions (ie TPA infusions or catheter exchange) to maintain flow or correct device failure.

Time frame: 30, 60 and 90 days

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.