Up to eight percent of patients develop steal syndrome after prosthetic dialysis access graft placement, which is characterized by low blood flow to the hand. Steal syndrome results in a cold hand, pain, and in extreme cases, loss of function and tissue damage. A practical and easy way of adjusting the fluidic resistance in a graft to attenuate the risk of steal physiology would greatly benefit both surgeons and patients. This paper describes the design and development of a device that can be attached to a dialysis access graft at the time of surgical implantation to enable providers to externally adjust the resistance of the graft postoperatively. Bench level flow experiments and magnetic setups were used to establish design requirements and test prototypes. The Graft Resistance Adjustment Mechanism (GRAM) can be applied to a standard graft before or after it is implanted and a non-contact magnetic coupling enables actuation through the skin for graft compression. The device features a winch-driven system to provide translational movement for a graft compression unit. We expect such a device to enable noninvasive management of steal syndrome in a manner that does not change the existing graft and support technologies, thus reducing patient complications and reducing costs to hospitals.
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bhopkins@mit.edu
hwu@seas.harvard.edu
whmarks@seas.harvard.edu
quan@fas.harvard.edu
skesner@seas.harvard.edu
cozaki1@partners.org
walsh@seas.harvard.edu
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June 2012
Research Papers
Hemodialysis Graft Resistance Adjustment Device
Brandon J. Hopkins,
Brandon J. Hopkins
School of Engineering and Applied Sciences,
bhopkins@mit.edu
Harvard University
, Cambridge, MA, 02138
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Huayin Wu,
Huayin Wu
School of Engineering and Applied Sciences,
hwu@seas.harvard.edu
Harvard University
, Cambridge, MA, 02138
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William H. Marks,
William H. Marks
School of Engineering and Applied Sciences,
whmarks@seas.harvard.edu
Harvard University
, Cambridge, MA, 02138
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Qimin Quan,
Qimin Quan
School of Engineering and Applied Sciences,
quan@fas.harvard.edu
Harvard University
, Cambridge, MA, 02138
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Samuel Kesner,
Samuel Kesner
School of Engineering and Applied Sciences,
skesner@seas.harvard.edu
Harvard University
, Cambridge, MA, 02138
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C. Keith Ozaki,
C. Keith Ozaki
Department of Vascular and Endovascular Surgery,
cozaki1@partners.org
Brigham and Women’s Hospital
, Boston, MA, 02115
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Conor Walsh
Conor Walsh
School of Engineering and Applied Sciences,
walsh@seas.harvard.edu
Harvard University
, Cambridge, MA, 02138
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Brandon J. Hopkins
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138bhopkins@mit.edu
Huayin Wu
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138hwu@seas.harvard.edu
William H. Marks
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138whmarks@seas.harvard.edu
Qimin Quan
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138quan@fas.harvard.edu
Samuel Kesner
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138skesner@seas.harvard.edu
C. Keith Ozaki
Department of Vascular and Endovascular Surgery,
Brigham and Women’s Hospital
, Boston, MA, 02115cozaki1@partners.org
Conor Walsh
School of Engineering and Applied Sciences,
Harvard University
, Cambridge, MA, 02138walsh@seas.harvard.edu
J. Med. Devices. Jun 2012, 6(2): 021011 (6 pages)
Published Online: May 7, 2012
Article history
Received:
November 4, 2011
Accepted:
February 20, 2012
Online:
May 7, 2012
Published:
May 7, 2012
Citation
Hopkins, B. J., Wu, H., Marks, W. H., Quan, Q., Kesner, S., Ozaki, C. K., and Walsh, C. (May 7, 2012). "Hemodialysis Graft Resistance Adjustment Device." ASME. J. Med. Devices. June 2012; 6(2): 021011. https://doi.org/10.1115/1.4006545
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