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Updated: Jul 18, 2026
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
[Vascular access for haemodyalisis. Comparative analysis of the mechanical behaviour of native vessels and
1Departamento de Fisiologia, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay.dbia@fmed.edu.uy
Insights
Cryopreserved vessels (cryografts) show less mechanical mismatch with native vessels compared to synthetic grafts like ePTFE. This finding suggests cryografts may improve vascular access for hemodialysis by reducing intimal hyperplasia and graft failure.
Area of Science:
- Biomedical Engineering
- Vascular Surgery
- Regenerative Medicine
Background:
- Vascular access prostheses for hemodialysis have low patency rates due to intimal hyperplasia, often caused by biomechanical mismatch with native vessels.
- Cryopreserved vessels (cryografts) are emerging as a potential alternative to synthetic grafts, but their biomechanical behavior relative to native vessels is not well understood.
Purpose of the Study:
- To compare the biomechanical properties of native human vessels (arteries and veins) with cryografts and expanded polytetrafluoroethylene (ePTFE) synthetic grafts.
- To evaluate the biomechanical mismatch between different vascular prostheses and native vessels used in vascular access.
Main Methods:
- Human arterial (humeral, carotid, femoral) and venous (saphenous) segments were cryopreserved for 30 days or tested fresh.
- Mechanical properties (compliance, distensibility, impedance) were measured under simulated hemodynamic conditions.
- Biomechanical mismatch was calculated between fresh native vessels, cryografts, and ePTFE prostheses.
Main Results:
- Expanded polytetrafluoroethylene (ePTFE) exhibited the highest mechanical mismatch with native vessels (p < 0.05).
- Venous and arterial cryografts demonstrated the least mechanical mismatch with native veins and arteries, respectively.
- The optimal prosthesis for minimizing mechanical mismatch varied depending on the specific native vessel and the mechanical parameter assessed.
Conclusions:
- Cryografts offer a reduced mechanical mismatch compared to synthetic prostheses like ePTFE when used as vascular access.
- Utilizing cryografts could potentially decrease intimal hyperplasia and improve graft patency in hemodialysis access by better matching native vessel biomechanics.
Introduction:
The prosthesis nowadays used in the vascular access for haemodialysis have low patency rates, mainly due to the luminal obstruction, determined by the intimal hyperplasia. Several factors have been related to de development of intimal hyperplasia and graft failure. Among them are the differences in the biomechanical properties between the prosthesis and the native vessels. In the searching for vascular prosthesis that overcomes the limitations of the currently used, the cryopreserved vessels (cryografts) appear as an alternative of growing interest. However, it is unknown if the mechanical differences or mismatch between prosthesis and native vessels are lesser when using cryografts.
Objective:
To characterize and compare the biomechanical behaviour of native vessels used in vascular access and cryografts. Additionally, segments of expanded polytetrafluoroethylene (ePTFE) were also evaluated, so as to evaluate the potential biomechanical advantages of the cryografts respect to synthetic prosthesis used in vascular access.
Methods:
Segments from human humeral (n = 12), carotid (n = 12) and femoral (n = 12) arteries, and saphenous vein (n = 12), were obtained from 6 multiorgan donors. The humeral arteries were studied in fresh state. The other segments were divided into two groups, and 6 segments from each vessel were studied in fresh state, while the remaining 6 segments were evaluated after 30 days of criopreservation. For the mechanical evaluation the vascular segments and 6 segments of ePTFE were mounted in a circulation mock and submitted to haemodynamic conditions similar to those of the in vivo. Instantaneous pressure (Konigsberg) and diameter (Sonomicrometry) were measured and used to calculate the viscous and elastic indexes, the compliance, distensibility and characteristic impedance. For each mechanical parameter studied, the mismatch between the prosthesis and the native vessel was evaluated.
Results:
The ePTFE was the prosthesis with the higher mechanical mismatch (p < 0.05). The venous and arterial cryografts showed the least mismatch with native veins and arteries, respectively. The prosthesis with the least mechanical mismatch was different, depending on the native vessel evaluated, and for a native vessel, on the parameter considered.
Conclusion:
The mechanical mismatch between the native vessel and the vascular prosthesis used in a vascular access could be reduced using cryografts.
