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Maintaining lower limb access with the HeRO device.

Marta J Madurska1, David B Kingsmore2,3, Karen S Stevenson4

  • 1Department of Vascular Surgery, Queen Elizabeth University Hospital, Marton Rd, Middlesbrough, Glasgow, TS4 3BW, UK. Marta.madurska@nhs.net.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
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PubMed
Summary
This summary is machine-generated.

The HeRO device, used to bypass central vein stenosis (CVS), shows promise for lower limb vascular access. This approach is feasible for both initial access and salvage procedures in patients with dialysis access complications.

Keywords:
Central vein occlusionCentral vein stenosisHeROLower limb vascular access

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Medical Devices

Background:

  • Central venous catheters (CVC) are crucial for dialysis access but can cause central vein stenosis (CVS) in up to 1 in 6 patients.
  • CVS may necessitate alternative access, such as in the groin, potentially leading to lower-body CVS, though this is underreported.
  • The HeRO device bypasses stenosed veins using a nitinol-reinforced tube to the right atrium, with established efficacy in the upper limb.

Observation:

  • This report details two cases of HeRO device utilization in the lower limb for vascular access.
  • One case involved primary access, while the other served as a salvage procedure for existing access.
  • Both lower limb HeRO devices remained functional post-implantation.

Findings:

  • The HeRO device is feasible for lower limb vascular access.
  • It can be effectively used as a primary (de novo) solution for establishing vascular access.
  • It also functions as a salvage procedure to maintain vascular access in challenging cases.

Implications:

  • Lower limb HeRO implantation offers a viable solution for patients experiencing CVS or access failure.
  • This expands the application of the HeRO device beyond the upper limb.
  • Further research is warranted to fully assess long-term outcomes and safety in lower limb applications.