title: In Vitro Study of a Medical Device to Enhance Arteriovenous Fistula Eligibility and Maturation.
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.
authors.affiliation: From the *Flow Forward Medical, Inc. (FFM), Lowell, Massachusetts; †School of Engineering, Griffith University, Southport, Queensland, Australia; ‡Department of Internal Medicine, Roy and Lucille Carver College of Medicine, University of Iowa and Veterans Affairs Medical Center, Iowa City, Iowa; and §FFM, Olathe, Kansas.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Loree
authors.forename: George
authors.initials: G
authors.lastname: Agyapong
authors.forename: Elyse G
authors.initials: EG
authors.lastname: Favreau
authors.forename: Gwendolyn A
authors.initials: GA
authors.lastname: Ngai
authors.forename: Geoff D
authors.initials: GD
authors.lastname: Tansley
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Dixon
authors.forename: F Nicholas
authors.initials: FN
authors.lastname: Franano
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D066298:In Vitro Techniques; D015918:Infusion Pumps, Implantable; D008954:Models, Biological; D006435:Renal Dialysis / Q000379:methods*; D014680:Veins