Journal: American Journal of Physiology - Renal Physiology

Article Title: Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability

doi: 10.1152/ajprenal.00440.2018

Figure Lengend Snippet: Arteriovenous fistula and graft. Representative images show a forearm radiocephalic arteriovenous fistula (AVF; A) and an upper arm brachiobasilic arteriovenous graft (AVG; B). [Reprinted from the Atlas of Dialysis Vascular Access with permission from Tuschar Vachharajani.]

Article Snippet: Secondary AVF patency Completed Vascular Therapies NCT02513303 Sirolimus-eluting collagen implant (AVF) Fistula suitability at 6 mo Ongoing phase III RCT in AVF Proteon Therapeutics NCT02110901 Elastase (AVF) 1 .

Techniques:

Journal: American Journal of Physiology - Renal Physiology

Article Title: Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability

doi: 10.1152/ajprenal.00440.2018

Figure Lengend Snippet: Angiography and histology of venous stenosis in arteriovenous fistulas (AVF) and arteriovenous grafts (AVG). Representative angiograms and histology of stenosis in a radiocephalic AVF (A and B) and AVG (C and D) are shown. A: venous stenosis is the common angiographic lesion seen in AVF maturation failure and AVG failure. Stenosis in AVF occurs most frequently in the juxta-anastomotic region of the AVF. In other types of AVFs, common areas of stenosis include the cephalic arch in brachiocephalic AVFs and proximal swing segment stenosis in transposed basilic vein transposition AVFs. B: intimal hyperplasia is the most common histological lesion present in AVF maturation failure. Stenosis in AVG occurs most commonly in the vein-graft anastomosis (C) with intimal hyperplasia being the most common histological legion present (D). NH, neointimal hyperplasia. [Adapted and reprinted from Ref. 62 with permission from American Society of Nephrology (62).]

Article Snippet: Secondary AVF patency Completed Vascular Therapies NCT02513303 Sirolimus-eluting collagen implant (AVF) Fistula suitability at 6 mo Ongoing phase III RCT in AVF Proteon Therapeutics NCT02110901 Elastase (AVF) 1 .

Techniques:

Journal: American Journal of Physiology - Renal Physiology

Article Title: Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability

doi: 10.1152/ajprenal.00440.2018

Figure Lengend Snippet: Mechanisms of arteriovenous fistula (AVF) maturation failure. Shown are the proposed cellular mechanisms associated with fistula nonmaturation. Because of the formation of the arteriovenous fistula, the already very high blood flow shifts from a laminar to turbulent system, exercising high wall shear stress (WSS) on the venous cells. Endothelial dysfunction, damage, and deendothelialization of the intimal layer due to WSS occurs, thus, exposing the subendothelial extracellular matrix (ECM) directly to flow. The exposed subendothelial layer results in thrombus formation as well as the adhesion and activation of platelets and monocytes. Monocytes infiltrate the vessel and differentiate to macrophages, releasing proinflammatory cytokines, such as TNF-α, monocyte chemoattractant protein (MCP)-1, and IL-8. Meanwhile, vascular smooth muscle cell (VSMC) migration and proliferation are promoted by platelet-derived growth factor (PDGF) and TNF-α. Driven by cytokines such as transforming growth factor (TGF)-β, TNF-α, and PDGF, fibroblasts differentiate to myofibroblasts, which proliferate and excrete ECM components.

Article Snippet: Secondary AVF patency Completed Vascular Therapies NCT02513303 Sirolimus-eluting collagen implant (AVF) Fistula suitability at 6 mo Ongoing phase III RCT in AVF Proteon Therapeutics NCT02110901 Elastase (AVF) 1 .

Techniques: Activation Assay, Migration, Derivative Assay

Journal: American Journal of Physiology - Renal Physiology

Article Title: Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability

doi: 10.1152/ajprenal.00440.2018

Figure Lengend Snippet: MRI and computational fluid dynamics (CFD) from human and animal arteriovenous conduits. A and D: MRI of a human arteriovenous fistula (AVF; A) and a mouse AVF (D). B and E: CFD results of a human AVF (B) and a porcine AVF (E). C and F: CFD results of a human arteriovenous graft (AVG; C) and a porcine AVG (F). [A and B: reprinted from Ref. 43 with permission from Elsevier; D: reprinted from Ref. 87 according to the BioMed Central license agreement; C: presented at the 2016 American Society of Nephrology Kidney Week Meeting (104); E and F: presented at the 2015 Summer Biomechanics, Bioengineering, and Biotransport Conference (88).]

Article Snippet: Secondary AVF patency Completed Vascular Therapies NCT02513303 Sirolimus-eluting collagen implant (AVF) Fistula suitability at 6 mo Ongoing phase III RCT in AVF Proteon Therapeutics NCT02110901 Elastase (AVF) 1 .

Techniques:

Journal: American Journal of Physiology - Renal Physiology

Article Title: Arteriovenous conduits for hemodialysis: how to better modulate the pathophysiological vascular response to optimize vascular access durability

doi: 10.1152/ajprenal.00440.2018

Figure Lengend Snippet: Clinical trials of local drug delivery approaches in AVFs and AVGs

Article Snippet: Secondary AVF patency Completed Vascular Therapies NCT02513303 Sirolimus-eluting collagen implant (AVF) Fistula suitability at 6 mo Ongoing phase III RCT in AVF Proteon Therapeutics NCT02110901 Elastase (AVF) 1 .

Techniques: Cell Culture