In Vitro Study of a Medical Device to Enhance Arteriovenous Fistula Eligibility and Maturation

ASAIO J. 2015 Jul-Aug;61(4):480-6. doi: 10.1097/MAT.0000000000000240.

Abstract

The arteriovenous fistula eligibility (AFE) system (Flow Forward Medical, Olathe, KS) is a small, temporary, wearable rotary blood pump system designed to rapidly dilate peripheral veins in hemodialysis patients and improve outcomes after arteriovenous fistula (AVF) creation. A benchtop pulsatile mock circulatory loop was developed to model forearm circulation and to compare the hemodynamics of the AFE system with those of a conventional radiocephalic AVF. The AFE system maintained a mean wall shear stress (mWSS) within the 2.5-7.5 Pa target range for cephalic outflow veins of 2-6 mm diameter, which when applied clinically will provide better control of mWSS during the outflow vein maturation process when compared with a conventional AVF. These results support further study to determine whether or not vein preconditioning with the AFE system under controlled levels of mWSS will promote improved AVF outcomes.

MeSH terms

  • Arteriovenous Shunt, Surgical / instrumentation*
  • Hemodynamics
  • Humans
  • In Vitro Techniques
  • Infusion Pumps, Implantable
  • Models, Biological*
  • Renal Dialysis / methods*
  • Veins