Continuous Suturing Versus Interrupted Clips for Brachiocephalic AV Fistula Creation

University of South Florida

Overview

The purpose of this study is to investigate a promising strategy to improve maturation and patency rates following creation of AV fistulas and assess whether an anastomosis performed with Anastoclips (interrupted, nonpenetrating) would produce better maturation and/or patency than one performed with conventional suturing techniques.

This will be a single blind (patient and dialysis center), prospective, randomized trial conducted at a single center. The study intervention will be randomization between conventional sutured anastomosis (Control group) and use of Anastoclips (Treatment group), which provide an interrupted closure without intimal penetration.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Conditions

Arteriovenous Fistula

Interventions

AV Fistula creation with suturesDEVICE

End-to-side anastomosis (of AV fistula) is to be constructed using sutures. The incision is to be irrigated and closed using Vicryl, Biosyn and skin glue.

AV Fistula creation with clipsDEVICE

End-to-side anastomosis (of AV fistula) is to be constructed using clips. The incision is to be irrigated and closed using Vicryl, Biosyn and skin glue.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Requiring brachiocephalic fistula judged to be best option for access after vein mapping (Surgeons will be required to do 10 cases using Anastoclips prior to enrolling) * Able to provide informed consent in English or Spanish * Age 18 years or greater * With estimated life expectancy of 2 years or more * Able to comply with study procedures including all scheduled follow-up visits Exclusion Criteria: * Unable to provide informed consent in English or Spanish * Age \< 18 years * With pacemaker, IACD, or other permanent obstructive device on that side (a temporary tunneled dialysis catheter is not an exclusion) * Unable (or in surgeon's judgment a poor risk) to comply with study procedures and follow-up visits * With estimated life expectancy of less than 2 years * Females must be either: * Of non-childbearing potential, which is defined as post-menopausal (at least 12 months without menses prior to Treatment Day) or documented surgically sterile or post hysterectomy (at least 1 month prior to Treatment Day) * Or, of childbearing potential, in which case must have a negative urine pregnancy test at Treatment Day

Locations (3)

Tampa General Hospital

Tampa, Florida, United States

University of South Florida - South Tampa Campus

Tampa, Florida, United States

USF Health Carol and Frank Morsani Center for Advanced Healthcare

Tampa, Florida, United States