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

Abstract

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.