Multicenter Study to Evaluate the Safety and Efficacy of SYMVESS™ in a Real World Setting in Patients With Extremity Arterial Injury Requiring Urgent Repair

A Phase 4, observational, multicenter, non-randomized, open-label post-marketing study in patients treated with commercially available Symvess for injuries to upper and lower extremities.

All eligible patients treated with Symvess for extremity vascular trauma, in accordance with the approved indication of the USPI. Eligible patients will be adults suitable for treatment with Symvess as a vascular conduit for extremity arterial injury when urgent revascularization is needed to avoid imminent limb loss, and autologous vein graft is not feasible.

Patients will be implanted with a Symvess as an interposition replacement or bypass using standard vascular surgical techniques. At least one anastomosis should be distal to or within the Axillary artery if repair is in upper extremity and either distal to or within the Femoral artery, if repair is in lower extremity.

Patients with injuries limited to the vessels of the heart, head and neck area or exclusively within the torso are not eligible for the study.

Each patient will be followed for up to 12 months post implantation. Post-implant assessments include the following:

• Full Physical Exam including surgical site
• Focused Vascular Assessment
• Clinical examination of the Symvess implant site
• Duplex Ultrasound to confirm patency of Symvess
• Documentation of any Symvess interventions
• Confirmation of compliance with antiplatelet therapy
• Concomitant Medications
• Assessment of Adverse Events

Inclusion criteria

• Aged at least 18 years old
• Patient is suitable to be implanted with a Symvess for extremity vascular trauma, in accordance with the approved indication of the USPI

• Symvess implant is to be used to re-establish blood flow to one of the major extremity arteries (see Section 4.1 for examples of size appropriate vessels)
• Although the proximal anastomosis may originate in the upper or lower torso region, the distal anastomosis must terminate in the extremity (e.g., below the inguinal crease for lower extremity, in the axillary or more distal in the upper extremity)
• Patient or legal representative is able, willing, and competent to give informed consent.
• Patient's life expectancy is at least 1 year based on the judgement of the Investigator
• Patient must have a home or place of residence whereby he/she may be contacted and a support system which would make them suitable for this study of one year follow-up duration
• Patient must have confirmed health insurance

Exclusion criteria

• Limb at a high risk of amputation due to nature of the initial injury in the judgement of the Investigator, despite adequate revascularization
• Patients lacking enough healthy muscle and/or soft tissue for adequate coverage of Symvess
• Known drug or alcohol abuse that in the opinion of the Investigator would preclude the patient from being suitable for long-term follow-up

a. Positive screen for illicit drugs (THC use is not exclusionary)

• Patient with known coagulopathies or hypercoagulable states (bleeding or clotting disorders)
• Known socioeconomic reasons (such as being homeless) that preclude the patient from being suitable for long-term follow-up
• Employee of the Sponsor or patient who is an employee or relative of the Investigator