Interdisciplinary BUMC Team Investigates Dialysis Access Malfunction

Awardees L to r: Alik Farber, MD, co-PI, vascular surgery; Mostafa Belghasem, PhD, pathology & laboratory medicine; Vipul Chitalia, MD, PhD, PD/PI, nephrology; Rajendran Vilvendhan, MBBS, co-PI, radiology; and Jean Francis, MD, nephrology. Not pictured: Thomas Szabo, PhD, biomedical engineering and Vijaya Kolachalama, PhD, computational biomedicine, will analyze mechanical properties of the stenosis.

Patients with chronic kidney disease frequently develop stenosis of their intrathoracic large veins (i.e., central venous stenosis), which jeopardizes their prospects of having a functional dialysis access, while the current modality to diagnose this complication is fraught with inaccuracies.

An interdisciplinary team of clinicians, biomedical engineers and scientists, including members of the Evans Center IBR Thrombosis and Hemostasis ARC, has taken on this challenge. They were awarded a grant by Philips to lead a clinical study focused on assessing the potential of intravenous ultrasound, an emerging technique, to investigate and diagnose the mechanical properties of central venous stenosis. Results from this study will address one of the critical bottlenecks in the management of dialysis access malfunction, particularly in the underserved patient population, and is likely to seed larger clinical trials in the future to guide endovascular therapies.