A Study of Routine Versus Selective Use of Ultrasound Scanning Prior to Haemodialysis Fistula Surgery
Recruitment status was Recruiting
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Purpose
Dialysis patients have their blood filtered by a machine as their kidneys no longer work. To get blood in and out of these patients it is possible to perform a surgical procedure to increase to size and durability of a vein in the arm to allow repeated needle insertion. This enlarged vein is called a fistula. There is some evidence that ultrasound scanning the blood vessels in the arm before surgery can improve the chances of a successful procedure. The investigators aim to test whether scanning all patients is better than scanning only those who are difficult to assess by physical examination alone.
| Condition | Intervention | Phase |
|---|---|---|
|
Haemodialysis Surgery |
Procedure: Arterial and venous duplex ultrasound examination |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Prospective Randomized Controlled Trial of the Clinical Effectiveness of Obligatory Versus Elective Duplex Ultrasound Scanning Prior to Arteriovenous Fistula Formation for Haemodialysis Vascular Access in a University Teaching Hospital. |
- Primary failure of access (immediate/early thrombosis or failure to mature). [ Time Frame: 30 days ] [ Designated as safety issue: No ]
- Assisted primary patency - being the interval from placement until the time of measurement of patency, including intervening manipulations [ Time Frame: open ended ] [ Designated as safety issue: No ]
- Secondary patency - The interval from placement until time of patency measurement including intervening manipulations [ Time Frame: open ended ] [ Designated as safety issue: No ]
- Site of fistula created [ Time Frame: within 1 month of recruitment ] [ Designated as safety issue: No ]
- Functional primary patency - being the interval from the time of access placement until any intervention designed to maintain or re-establish patency or the time of measurement of patency during which the AVF provides dialysis access. [ Time Frame: open ended ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 150 |
| Study Start Date: | March 2010 |
| Estimated Study Completion Date: | January 2012 |
| Estimated Primary Completion Date: | November 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: Control group - selective duplex
Patients will receive a duplex ultrasound only if specifically requested following physical examination.
|
Procedure: Arterial and venous duplex ultrasound examination
Ultrasound mapping of all blood vessels in the upper limb of interest
|
|
Experimental: Obligatory Duplex scan
Patients will receive a duplex ultrasound regardless of clinical findings.
|
Procedure: Arterial and venous duplex ultrasound examination
Ultrasound mapping of all blood vessels in the upper limb of interest
|
Detailed Description:
We will recruit all patients undergoing primary vascular access procedures in our unit who meet inclusion criteria. They will be randomised to either surgery based on clinical findings with duplex ultrasound only if requested by surgeon, or routine duplex ultrasound prior to surgery.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Specific inclusion criteria necessary for invitation to study participation; Patients referred to vascular consultants for primary AV fistula formation (or primary fistula in that limb) for haemodialysis access.
General inclusion criteria;
- Ability to give informed written consent
Exclusion Criteria:
Specific exclusion criteria;
- Previous arterial or venous surgery/intervention performed on target limb.
- Known thrombophilic or thrombotic pathology.
- Aged under 18 at time of referral
General exclusion criteria;
- Inability to give informed written consent
- Inability to attend follow up appointments
Contacts and Locations| Contact: George E Smith, MBBS MRCS | 01482 675523 | george.smith@hey.nhs.uk |
| Contact: Ian C Chetter, MBChB MD FRCS | 01482665523 | ian.chetter@hey.nhs.uk |
| United Kingdom | |
| Hull Royal Infirmary | Recruiting |
| Hull, United Kingdom, HU3 2JZ | |
| Contact: George E Smith, BSc MBBS MRCS 01482 675523 george.smith@hey.nhs.uk | |
| Contact: Ian C Chetter, MBChB FRCS MD 01482 674765 ian.chetter@hey.nhs.uk | |
| Sub-Investigator: George E Smith, BSc MBBS MRCS | |
| Principal Investigator: Ian C Chetter, MBChB FRCS MD | |
| Principal Investigator: | Ian C Chetter, MBChB FRCS MD | Hull University |
More Information
No publications provided
| Responsible Party: | Mr IC Chetter, Hull University |
| ClinicalTrials.gov Identifier: | NCT01004627 History of Changes |
| Other Study ID Numbers: | Access 1 |
| Study First Received: | October 29, 2009 |
| Last Updated: | July 19, 2011 |
| Health Authority: | United Kingdom: National Health Service |
Keywords provided by University of Hull:
|
fistula ultrasound angioaccess |
preoperative vein mapping Haemodialysis Angioaccess surgery |
Additional relevant MeSH terms:
|
Arteriovenous Fistula Fistula Arteriovenous Malformations Vascular Malformations Cardiovascular Abnormalities |
Cardiovascular Diseases Vascular Fistula Vascular Diseases Congenital Abnormalities Pathological Conditions, Anatomical |
ClinicalTrials.gov processed this record on May 22, 2013