Central venous stenosis is a common and serious vascular complication among long-term hemodialysis patients that can lead to the loss of vascular access and a diminished life expectancy.
The HeRO Graft (Hemodialysis Reliable Outflow) is the only fully subcutaneous AV access solution clinically proven to maintain long-term access for hemodialysis patients with central venous stenosis.
Key Features & Benefits (compared to catheters)
- 69% fewer infections.2
- 16-32% improved dialysis clearance of toxins and fluids (Kt/V).2
- Less than half the interventions to keep access functioning.2
- Patency rates comparable to AVG.3
The Super HeRO Adapter and Support Seal system expands upon the clinically proven HeRO Graft by allowing surgeons to utilize other standard wall and early cannulation vascular graft options.
The current clinical approach when treating dialysis patients with chronically occluded central veins is to use another vein if a subsequent central venous catheter is needed. Failed venous access attempts may prevent permanent arteriovenous access, increasing patient morbidity and the overall cost of care.4
Designed to gain central venous access, the Surfacer System works by inserting the device through the right femoral vein and navigating it up through the patient’s venous system with an exit point in the right internal jugular vein, the optimal location for placing a central venous catheter.
Key Features & Benefits
- Preserves the viability of secondary central veins.
- Supports the achievement of permanent AV access, which reduces hemodialysis provider cost and downtime by decreasing catheter-associated morbidity and complications.5
- Easier, minimally invasive procedure compared to surgical bypass for patients with totally occluded central veins.
Compared to in-center hemodialysis, home dialysis patient advantages include more profound improvements in blood pressure control, better kidney disease-related quality of life, and shorter recovery time from dialysis treatments. Such benefits are also associated with peritoneal dialysis (PD) compared to in-center hemodialysis.
We offer a line of Flex-neck PD Catheters that are available in various shapes and sizes to accommodate tunneling techniques and exit site options. Our adult catheters have an internal diameter of 3.5 mm, allowing up to 30% higher flow rates than competitors (with 2.6 mm internal diameter). Infant catheters are available in one and two cuff configurations. Each catheter kit contains a unique stenciling system for improved placement accuracy.
Key Features & Benefits
- Large internal diameter.
- Available in a range of sizes for adult, adolescent, pediatric, and infant patients.
- PD accessories as well as Laparoscopic and Percutaneous Implantation Kits are available to streamline procedures and promote efficiency.
Hemodialysis access failures take a great toll on a patient’s quality of life. Frequent hospital admissions, invasive diagnostic tests, and open and endovascular reinterventions are associated with increased morbidity.6 Maintaining vessel patency in hemodialysis patients is critical; however, surgical access durability is temporary at best, with half-life for arteriovenous grafts lasting approximately one year and arteriovenous fistulas providing only slightly better outcomes.6 A common failure of hemodialysis access is stenosis or occlusion of the dialysis outflow circuit. Obstructions caused by cellular migration and tissue accumulation across graft ePTFE layers can be a contributing factor.
Addressing this clinical challenge, Merit Medical® introduced the Merit WRAPSODY™, a novel endoprosthesis designed with a revolutionary cell-impermeable middle graft layer. With this unique feature, the Merit WRAPSODY Endoprosthesis inhibits transmural cellular migration without the use of drug bonding, helping to prevent obstructions from forming within the endoprosthesis.
Key Features & Benefits
- Inhibits transmural cellular migration without the use of drug bonding
- Provides a viable treatment option that preserves functional hemodialysis access
- Biocompatible ePTFE material that allows for necessary tissue ingrowth to prevent stent migration
Our line of Prelude® Sheath Introducers are part of the innovative family of Merit vascular access products. These products offer excellent transitions, kink resistance, smooth insertion, and more to make accessing your patient easy and convenient. The hemostasis valve minimizes blood leakage during procedures and these introducers are available in custom kit options to meet your clinical needs.
As the most patent catheters on the market, the Centros (without side holes) and the CentrosFLO (with side holes) long-term hemodialysis catheters feature self-centering curved tips which automatically center the catheter ports within the middle of the vessel to maintain optimal blood flow and minimal recirculation rates, enhancing overall catheter performance.
ProGuide chronic dialysis catheters are designed for optimal patient comfort, ease of insertion, and maintenance. Multiple kit options are available for insertions through a valved peel-away sheath or over-the-wire placements.
The Dynamis AV is a dilatation balloon catheter indicated for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistulae.
ADVOCATE™ PTA CATHETERS
When it comes to peripheral intervention, having a wide variety of available product and treatment options is important. The Advocate PTA balloon catheter portfolio facilitates demand for versatility by combining unique configurations into a broad matrix of balloon sizes and catheter lengths.
BASIXTOUCH™ INFLATION DEVICE
The basixTOUCH provides expanded capacity for inflation. With 35 ATM pressure capability and 30 mL syringe volume, the basixTOUCH is ideal for any interventional lab using high-pressure, large-volume balloons. With wider threads and quick-release handle, the basixTOUCH offers rapid inflation and deflation to busy labs that need top efficiency.
SEADRAGON2™ TORQUE DEVICE
Operable with one hand, this ergonomic torque device is designed to enhance manipulation of the guide wire tip. Simply squeeze and release.
SLIP-NOT® SUTURE RETENTION DEVICE
The Slip-Not Suture Retention Device helps manage bleeding after an AV fistula intervention by utilizing a novel method to secure your purse-string suture. Suture tension adjustments are achieved at the push of a button.
OUTAKE® CATHETER EXTRACTOR
The OuTake Catheter Extractor is a convenient, simple, and cost-effective device used to remove tunneled double lumen hemodialysis catheters with an ingrown cuff.
CLINICIAN TRAINING & SUPPORT
For Physicians: Virtual Percutaneous PD Webinar
In this webinar, gain an overview and learn about components of percutaneous PD with Dr. Peter B. Hathaway, a nationally recognized leader in PD catheter placement.
Course topics include:
- Current PD environment
- Pre-operative assessment and prep
- Ultrasound techniques
- Percutaneous PD tools and kits
- Patient stenciling
- PD catheter implantation
- Tunneling techniques
- Complications and trouble shooting
- And more
For Other Clinicians: Virtual Dialysis Access CE Program
Earn continuing education credits with our Virtual Dialysis Access CE Program. Designed for nurses, dialysis technicians, and other healthcare professionals, this program offers and overview of dialysis access by outlining the types of access available and the order of preference for use.
Program topics include:
- Overview of dialysis access
- Order of preference for dialysis access
- Types of dialysis access: AV fistula, AV graft, hemodialysis catheters, PD
To register for these virtual training opportunities as well as learn about our Think Dialysis Access™ physician education program, visit here.
Clinical Case Support
To better aid physicians in dialysis access cases, we also have a dedicated team of dialysis access clinical specialists who understand the intricacies of hemodialysis and PD and are ready to support you. From explaining correct Merit product use to on-site troubleshooting, Merit clinical specialists are available to assist. Connect with a Merit clinical specialist today.
- University of California San Francisco. 2018. “The Kidney Project.” https://pharm.ucsf.edu/kidney/need/statistics
- Initial Experience and Outcome of a New Hemodialysis Access Device for Catheter-Dependent Patients.Howard E. Katzman, Robert B. McLafferty, John R. Ross, Marc H. Glickman, Eric K. Peden and Jeffrey H. Lawson. JVS, Journal of Vascular Surgery, September 2009 Volume 50, Issue 3, Pages 600-607.e1
- Gage et al. 2012. EJVES.
- Data on file at Bluegrass Vascular Technologies, Inc.
- Data on file.
- Rodriguez, Eduardo, et al. 2017. “Hemodialysis Outflow Vein Stenosis.” In Hemodialysis Access Fundamentals and Advanced Management, edited by Sherene Shalhub, Anahita Dua, and Susanna Shin, 257–263. Switzerland: Springer International Publishing.