Dialysis Access Dysfunction Treatment Device

Project Summary Abstract We propose the development of a novel compliant silicone impeller based rotating thrombectomy tool for improving the safety and efficacy of dialysis accessHemodialysis requires functional vascular access facilitated by hemodialysis fistulaswhich are a surgically created communication between the native artery and vein in an extremityThe creation and maintenance of a well functioning dialysis vascular access remains a major contributor to morbidity and mortality in patients with end stage renal diseaseThe cost of vascular access care is high among patients with arteriovenous fistulaAVFthrombosis and highest for patients selected for central venous catheterizationIn a retrospective studyit was observed that salvaging thrombosed AVFs by percutaneous thrombectomy is a safe and cost effective policyand thereforerecommended that intensive efforts should be undertaken to universalize these proceduresThere exists great enthusiasm for percutaneous dialysis access interventions to resolve thrombosis symptomsThrombectomy devices on the market have high costs and are not optimized for fistula and graft treatmentThe proposed project explores a novel tool to remove thrombotic material that we hypothesize will result in safer and more effective dialysis access interventional procedures and improved long term patient outcomesA prototype device will be developed and evaluated Project Narrative The proposed project relates to the development of tools to maintain vascular access for dialysisThe creation and maintenance of a well functioning dialysis vascular access remains a major contributor to the morbidity and mortality seen in patients with end stage renal diseaseESRDInthe USRDS data documents that there wereMedicare dependents on dialysis in the USFrom Medicare datait has also been estimated that vascular access dysfunction is responsible forof all hospitalizations in the hemodialysis populationExpenditures on dialysis on dialysis vascular access contribute $billion annually to the ESRD patient costs