A soft thermal sensor for the continuous assessment of flow in vascular access

• Published in: Nature communications Vol. 16; no. 1; pp. 38 - 13
• Main Authors: Deng, Yujun, Arafa, Hany M., Yang, Tianyu, Albadawi, Hassan, Fowl, Richard J., Zhang, Zefu, Kandula, Viswajit, Ramesh, Ashvita, Correia, Chase, Huang, Yonggang, Oklu, Rahmi, Rogers, John A., Carlini, Andrea S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.01.2025; Nature Publishing Group; Nature Portfolio
• Subjects: 119/118; 639/166/985; 692/699/1585/2159/1765; Animal models; Animals; Arteriovenous Shunt, Surgical; Blood flow; Clinical trials; Failure; Finite Element Analysis; Finite element method; Hemodialysis; Humanities and Social Sciences; Humans; Kidney diseases; Kidneys; Mathematical models; Monitoring, Physiologic - instrumentation; Monitoring, Physiologic - methods; multidisciplinary; Occlusion; Portable equipment; Real time; Renal Dialysis - instrumentation; Renal failure; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - therapy; Science; Science (multidisciplinary); Stenosis; Surgical instruments; Survival; Swine; Thromboembolism; Thrombosis; Vascular Access Devices; Velocity measurement; Venous access; Wearable Electronic Devices; Wearable technology
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-024-54942-3

Hemodialysis for chronic kidney disease (CKD) relies on vascular access (VA) devices, such as arteriovenous fistulas (AVF), grafts (AVG), or catheters, to maintain blood flow. Nonetheless, unpredictable progressive vascular stenosis due to neointimal formation or complete occlusion from acute thrombosis remains the primary cause of mature VA failure. Despite emergent surgical intervention efforts, the lack of a reliable early detection tool significantly reduces patient outcomes and survival rates. This study introduces a soft, wearable device that continuously monitors blood flow for early detection of VA failure. Using thermal anemometry, integrated sensors noninvasively measure flow changes in large vessels. Bench testing with AVF and AVG models shows agreement with finite element analysis (FEA) simulations, while human and preclinical swine trials demonstrate the device’s sensitivity. Wireless adaptation could enable at-home monitoring, improving detection of VA-related complications and survival in CKD patients. Vascular access failure in subjects with chronic kidney diseases undergoing hemodialysis significantly reduces survival rates. Here, the authors introduce a portable device to detect early failure with high sensitivity and real-time thrombosis detection.