More than 500,000 U.S. patients have end stage renal disease, and over 80% of them utilize hemodialysis. A significant problem for dialysis patients is the development of a functioning and durable vascular access, preferably an arteriovenous fistula (AVF). After creation, about 60% of AVFs fail to mature successfully for dialysis use. This is due to inadequate vasodilation and smooth muscle cell hyperplasia at the distal venous anastomosis.
A vascular wrap and gel incorporating the Endomimetics bionanomatrix has been developed. These are used to wrap the AVF at the time of creation, recruiting endothelial cells and enhancing appropriate vasodilation, both necessary for proper maturation. Additionally, the coating limits smooth muscle cell proliferation, which is also of benefit in that smooth muscle proliferation plays a significant role in AVF non-maturation. This wrap coating is undergoing preclinical evaluation in collaboration with a group at the University of Alabama at Birmingham,