A5085319772- Central Venous Catheters and Hemodialysis
- Vascular Procedures and Complications
- Vascular Malformations Diagnosis and Treatment
- Vascular anomalies and interventions
- Intracranial Aneurysms: Treatment and Complications
- Eicosanoids and Hypertension Pharmacology
- Migraine and Headache Studies
- Dialysis and Renal Disease Management
- Renal and Vascular Pathologies
- Autophagy in Disease and Therapy
- Electrospun Nanofibers in Biomedical Applications
- Cardiac Arrhythmias and Treatments
- Chronic Kidney Disease and Diabetes
- Advanced Glycation End Products research
- Cellular Mechanics and Interactions
- Coronary Interventions and Diagnostics
- Blood Coagulation and Thrombosis Mechanisms
- Heme Oxygenase-1 and Carbon Monoxide
- Cardiovascular Effects of Exercise
- Retinal Diseases and Treatments
- Cardiac Ischemia and Reperfusion
- Renin-Angiotensin System Studies
- Cardiovascular, Neuropeptides, and Oxidative Stress Research
- Single-cell and spatial transcriptomics
- Microbial metabolism and enzyme function
University of Utah
2016-2025
George E. Wahlen Department of VA Medical Center
2024-2025
Veterans Health Administration
2020-2023
VA Salt Lake City Healthcare System
2017-2023
Hypertension Institute
2017-2020
Background The utility of early postoperative ultrasound measurements in predicting arteriovenous fistula (AVF) clinical maturation is uncertain. Methods We investigated the relationships parameters with AVF newly created AVF, measured at 1 day and 2 6 weeks, 602 participants a multicenter, observational cohort study. A backward elimination algorithm identified that independently predicted unassisted overall maturation. Candidate variables included blood flow, diameter, depth, upper arm...
Intimal hyperplasia and stenosis are often cited as causes of arteriovenous fistula maturation failure, but definitive evidence is lacking. We examined the associations among preexisting venous intimal hyperplasia, after creation, clinical failure. The Hemodialysis Fistula Maturation Study prospectively observed 602 men women through creation surgery their postoperative course. A segment vein used to create was collected intraoperatively for histomorphometric examination. On ultrasounds...
Purpose To assess the anatomic development of native arteriovenous fistula (AVF) during first 6 weeks after creation by using ultrasonographic (US) measurements in a multicenter hemodialysis maturation study. Materials and Methods Each institutional review board approved prospective study protocol, written informed consent was obtained. Six hundred two participants (180 women 422 men, 459 with upper-arm AVF 143 forearm AVF) from seven clinical centers underwent preoperative artery vein US...
Arteriovenous fistula (AVF) maturation failure is the primary cause of dialysis vascular access dysfunction. To evaluate whether preoperative functional properties predict postoperative AVF measurements, patients enrolled in Hemodialysis Fistula Maturation Study underwent up to five function tests (VFTs): flow-mediated dilation (FMD), nitroglycerin-mediated (NMD), carotid-femoral pulse wave velocity, carotid-radial and venous occlusion plethysmography. We used mixed effects multiple...
Stenosis from venous neointimal hyperplasia is common in native arteriovenous fistulas (AVFs). However, the preexisting histologic characteristics of veins at fistula creation, and associations thereof with baseline patient factors, have not been well characterized. In this study, we conducted analysis a segment vein used for anastomosis obtained during AVF creation 554 602 participants multicenter Hemodialysis Fistula Maturation Cohort Study. We quantified intimal medial areas lengths...
Continuous laminar shear stress increases the process of autophagy, activates endothelial nitric oxide (NO) synthase phosphorylation at serine 1177 (p-eNOSS1177), and generates NO in bovine human arterial cells (ECs) compared with static controls. However, translational relevance these findings has not been explored. In current study, primary ECs were collected from radial artery 7 men using sterile J-wires before (Pre) after (Post) 60 min rhythmic handgrip exercise (HG) performed same arm....
Vascular access is the lifeline for hemodialysis patients and single most important component of procedure. Arteriovenous fistula (AVF) preferred vascular patients, but nearly 60% AVFs created fail to successfully mature due early intimal hyperplasia development poor outward remodeling. There are currently no therapies available prevent AVF maturation failure. First, we showed regulatory role nitric oxide (NO) on by demonstrating that was reduced in an overexpressed endothelial synthase...
Abstract The pathogenesis of arteriovenous fistula (AVF) maturation failure is unclear. We evaluated the associations wall shear stress (WSS) with subsequent AVF remodeling and clinical using regression models in this prospective cohort study. Participants underwent duplex ultrasound at postoperative Day 1, Week 2, 6 to measure blood flow rate diameter draining vein proximal artery. median WSS 602 participants decreased from 1 (from 33.4 21.6 dyne/cm 2 ) but did not change noticeably for...
1Division of Nephrology and Hypertension, Department Internal Medicine, Spencer Fox Eccles School University Utah, Salt Lake City, Utah 2Cardiovascular, Renal, Metabolism Center, 3George E. Wahlen Veterans Affairs Medical 4Nora Harrison Cardiovascular Research Training Institute, Correspondence: Prof. Yan-Ting Shiu, email: [email protected] See related article, "Interplay between Skeletal Muscle Catabolism Remodeling Arteriovenous Fistula by Yes-Associated Protein 1 (YAP1) Signaling," on...
Background and objectives HDL particles obtained from patients on chronic hemodialysis exhibit lower cholesterol efflux capacity are enriched in inflammatory proteins compared with those healthy individuals. Observed alterations could be due to effects of CKD, but also may influenced by the procedure, which stimulates proinflammatory prothrombotic pathways. Design, setting, participants, & measurements We HDL-associated 143 participants who initiated within previous year 110 advanced CKD...
Abstract Creation of a hemodialysis arteriovenous fistula (AVF) causes aberrant vascular mechanics at and near the AVF anastomosis. When inadequately regulated, these mechanical factors may impede lumen expansion to cause maturation failure, significant clinical problem with no effective treatments. The endothelial nitric oxide synthase (NOS3) system is crucial for health function, but its effect on has not been fully characterized. We hypothesize that NOS3 promotes by regulating local...
Blood flow-induced wall shear stress is a strong local regulator of vascular remodeling, but its effects on arteriovenous fistula (AVF) remodeling are unclear.
Following creation, an arteriovenous fistula (AVF) must mature (i.e., enlarge lumen to allow high blood flow) before being used for hemodialysis. AVF maturation failure rates are high, and currently, there no effective therapy treat this problem. The process is likely affected by the integrity of vascular extracellular matrix (ECM). Natural Vascular Scaffolding (NVS) Therapy a new technology that interlinks collagen elastin via photoactivation locally delivered small molecule...
Abstract Background Arteriovenous fistula (AVF) is the most important vascular access for hemodialysis; however, preventive treatment to maintain patency of AVFs has not been developed. In endothelium, β-catenin functions in both intercellular adherens complex and signaling pathways that induce transition endothelial cells myofibroblasts response mechanical stimuli. We hypothesize disturbances AVF activate leading myofibroblasts, which cause thickening. The present study aimed test this...
Background The arteriovenous fistula (AVF) is the preferred hemodialysis access for patients with ESKD. Yet, establishment of a functional AVF presents challenge, even most experienced surgeons, because postoperative stenosis frequently occludes AVF. Stenosis results from loss compliance in fibrotic areas fistula, which turns intimal hyperplasia into an occlusive feature. Fibrotic remodeling depends on deposition and crosslinking collagen by lysyl oxidase (LOX), enzyme that catalyzes...
A significant number of arteriovenous fistulas (AVFs) fail to maturate for dialysis. Although interventions promote maturation, functional primary patency loss is higher AVFs with (assisted maturation) than without (un-assisted maturation). blood flow-associated hemodynamics have long been proposed affect AVF remodeling, the optimal hemodynamic parameters un-assisted maturation are unclear. Additionally, progress generally not investigated until 6 weeks after creation, and examination...
Introduction: Several histologic features have been identified in the upper-extremity arteries and veins of patients with advanced chronic kidney disease, which may affect arteriovenous fistula maturation. However, it is unclear whether these disease vascular are abnormal. Methods: We obtained arterial venous specimens from 125 undergoing creation 15 control subjects. quantified medial fibrosis, micro-calcification, intimal hyperplasia appropriate histology stains. characterized collagen...
Background and objectives Preoperative arterial function is associated with arteriovenous fistula (AVF) development. Because pathology may correlate its function, preexisting intimal hyperplasia be AVF Design, setting, participants, & measurements Vascular specimens obtained from 125 patients (with minimal 2 mm diameter 2.5 venous diameter) undergoing creation were quantified for hyperplasia, medial fibrosis, microcalcification, hyperplasia. A 6-week postoperative ultrasound diameter,...
Background Arteriovenous fistula (AVF) maturation failure is a significant clinical problem in the hemodialysis population. Geometric parameters of human AVFs were associated with AVF development, but causative studies are lacking. We characterized mouse geometry using endothelial nitric oxide synthase (NOS3) models. Methods Carotid-jugular created NOS3 overexpression (OE), knockout (KO), and wild-type (WT) mice. At 7 21 days postcreation, black-blood magnetic resonance images acquired used...
Arteriovenous hemodialysis graft (AVG) stenosis results in thrombosis and AVG failure, but prevention of has been unsuccessful due large part to our limited understanding the molecular processes involved neointimal hyperplasia (NH) formation. develops chiefly as a consequence highly localized NH formation vein-graft anastomosis region. Surprisingly, vein region just downstream (herein termed proximal region) is relatively resistant NH. We hypothesized that gene expression profiles NH-prone...