Canaud Bernard, Hammed Abdessalem, Karsenti Alexandre, Canaud Ludovic, Jean Eric, Vrinat Jean-Marie, Fessi Hafedh, Ayoub Jean-Yves, Rys Michael, Louzier Vanessa
Faculty of Medicine, University of Montpellier, Montpellier, France.
UR APCSe Agressions Pulmonaires et Circulatoires Dans le Sepsis, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France.
J Vasc Surg Cases Innov Tech. 2025 Sep 13;11(6):101983. doi: 10.1016/j.jvscit.2025.101983. eCollection 2025 Dec.
Vascular access remains a critical challenge in kidney replacement therapy. Although arteriovenous fistulas are the reference standard, they are often compromised by maturation failure, complications, and repeated needling, which causes pain and distress for patients. A needle-free alternative could enhance safety, simplify use, and improve the patient experience, particularly in self-care and home dialysis. We evaluated the Safe Hemodialysis Implantable Vascular Access Technology arteriovenous port, a patented titanium device incorporating a twist-lock system anastomosed to a vascular graft prosthesis. The proof-of-concept study included in vitro testing to assess flow performance, durability, and hemocompatibility, followed by implantation in two sheep to determine surgical feasibility, hemodynamic function, and safety during a sham hemodialysis session. Implantation was successful without complications, the twist-lock system functioned securely, and no blood leakage, arterial bleeding, or air embolism occurred. The device provided adequate blood flow, although refinements are required to achieve clinical targets of 300-400 mL/min. These preliminary findings suggest that the Safe Hemodialysis Implantable Vascular Access Technology port is a feasible and safe needle-free vascular access concept, with potential to reduce needling burden, improve handling, and minimize infection risk in clinical use.
血管通路仍然是肾脏替代治疗中的一项关键挑战。尽管动静脉内瘘是参考标准,但它们常常因成熟失败、并发症和反复穿刺而受到影响,这给患者带来疼痛和困扰。一种无需穿刺的替代方法可以提高安全性、简化使用并改善患者体验,尤其是在自我护理和家庭透析方面。我们评估了安全血液透析植入式血管通路技术动静脉端口,这是一种获得专利的钛制装置,包含一个扭锁系统,与血管移植假体吻合。这项概念验证研究包括体外测试,以评估血流性能、耐用性和血液相容性,随后在两只绵羊身上进行植入,以确定假血液透析过程中的手术可行性、血流动力学功能和安全性。植入成功且无并发症,扭锁系统运行可靠,未发生血液渗漏、动脉出血或空气栓塞。该装置提供了足够的血流量,不过要达到300 - 400毫升/分钟的临床目标还需要改进。这些初步研究结果表明,安全血液透析植入式血管通路技术端口是一种可行且安全的无需穿刺的血管通路概念,有可能在临床使用中减轻穿刺负担、改善操作并将感染风险降至最低。