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Mesenchymal stem cell (MSC)-seeded polymeric perivascular wraps have been shown to enhance arteriovenous fistula (AVF) maturation. However, the wraps' radiolucency makes their placement and integrity difficult to monitor. Through electrospinning, we infused gold nanoparticles (AuNPs) into polycaprolactone (PCL) wraps to improve their radiopacity and tested whether infusion affects the previously reported beneficial effects of the wraps on the AVF's outflow vein. Sprague Dawley rat MSCs were seeded on the surface of the wraps. We then compared the effects of five AVF treatments-no perivascular wrap (i.e., control), PCL wrap, PCL + MSC wrap, PCL-Au wrap, and PCL-Au + MSC wrap-on AVF maturation in a Sprague Dawley rat model of chronic kidney disease (n = 3 per group). Via micro-CT, AuNP-infused wraps demonstrated a significantly higher radiopacity compared to that of the wraps without AuNPs. Wraps with and without AuNPs equally reduced vascular stenoses, as seen via ultrasonography and histomorphometry. In the immunofluorescence analysis, representative MSC-seeded wraps demonstrated reduced neointimal staining for markers of infiltration with smooth muscle cells (α-SMA), inflammatory cells (CD45), and fibroblasts (vimentin) compared to that of the control and wraps without MSCs. In conclusion, AuNP infusion allows in vivo monitoring via micro-CT of MSC-seeded polymeric wraps over time, without compromising the benefits of the wrap for AVF maturation.
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http://dx.doi.org/10.3390/ijms241411754 | DOI Listing |
J Vasc Access
September 2025
Prince of Wales Hospital, Sydney, NSW, Australia.
Objective: Minimal Invasive Dialysis Access (MIDA) for renal dialysis encompasses percutaneous arteriovenous fistula (pAVF) creation and the modified percutaneous Seldinger peritoneal dialysis catheter insertions (pPD). This review examines the impact of MIDA on technical success, maturation rates, patency, clinical benefits, complications, and cost.
Methods: A review was made of the literature on MIDA including pAVF creation and pPD insertion regarding technical success rates, maturation rates, patency, clinical benefits, complications, and cost.
Clin J Am Soc Nephrol
September 2025
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL.
For many years, the vascular access guidelines recommended placement of arteriovenous fistulas (AVFs) in preference to arteriovenous grafts (AVGs) because AVFs had superior long-term patency, required fewer interventions to maintain patency, and were associated with lower costs of vascular access management. However, subsequent research has questioned the "Fistula First strategy" (placing an AVF whenever the vascular anatomy is suitable). First, AVF non-maturation is substantial (30-40%), and even higher among women, older patients and those with peripheral vascular disease.
View Article and Find Full Text PDFAnn Vasc Surg
September 2025
Interventional Radiology, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Objectives: As a two-dimensional modality, venography has limitations in its capacity to measure lumen caliber and to assess stenotic disease accurately. This has implications in the management of end-stage renal-disease (ESRD) patients "no-option" candidates access for arteriovenous fistula (AVF) or graft (AVG) creation secondary to high risk of vascular access failure. The incremental diagnostic and clinical impact of intravascular ultrasound (IVUS) was quantified in this tunneled dialysis catheter dependent ESRD cohort.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida, Gainesville.
Importance: Predialysis nephrology care is associated with the likelihood of having a mature, usable arteriovenous access for starting hemodialysis (ie, incident vascular access), a key care quality metric for patients with kidney failure. However, the magnitude of this association has not been quantified to date.
Objective: To quantify the attributable association between lack of access to predialysis nephrology care and incident vascular access outcomes among Hispanic patients.
Sci Transl Med
August 2025
Vascular and Interventional Radiology Translational Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Worldwide, more than 4 million patients with end-stage kidney disease require hemodialysis through an arteriovenous fistula (AVF). AVFs fail because of venous neointimal hyperplasia (VNH) resulting in venous stenosis formation. A phase 1 randomized trial in patients undergoing upper extremity AVF placement was performed to evaluate the safety and efficacy of autologous adipose-derived mesenchymal stem cells (MSCs) in improving AVF function.
View Article and Find Full Text PDF