Many of the previously suggested associations found with CVI are in reality due to this population's greater age. Patients with CVI are older, male, obese, have a history of phlebitis, and have a history of serious leg injury. These results suggest that a prior deep vein thrombosis, either clinical or subclinical, may be a predisposing factor for CVI.

Linear healing per day is a valid means of comparing wound healing rates in wounds of different dimensions. Linear healing per unit of time should be preferred to measurements of change in wound area to quantify wound healing rates in clinical trials.

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increased when siRNA was complexed with PEI. The amount of siRNA adsorbed generally appeared greater in ePET than in PTFE fabrics. Repeated dipping of ePET in siGLO Red/PEI solution significantly increased siRNA adsorption vs single dipping.Conclusions: siRNA adsorption to ePET and PTFE surfaces is significantly increased if the siRNA is complexed with PEI. Preliminary data in this study suggest that siRNA adsorbs better to ePET than PTFE. Further, repeated dipping of ePET additionally increased adsorption of siRNA to fabric. Thus, coating of ePET with siRNA/PEI may be a method to improve graft patency.Introduction and objectives: Eph-B4, the receptor tyrosine kinase that serves as the embryonic venous fate determinant, is decreased in association with the successful adaptation of surgical vein grafts to the arterial environment. Stimulation of Eph-B4 recovers the native phenotype. However, the Ephrin-B2 protein, the juxtacrine ligand for Eph-B4, is not expressed in veins; as such, the adult physiologic controller of Eph-B4 is unknown. We explored whether the mechanosensitive integrin-␤-1 molecule is an upstream regulator of Eph-B4 signaling.Methods: Eph-B4 -positive endothelial cells and Eph-B4 -negative Cos cells transfected with wild-type or mutant W804A Eph-B4 were stimulated with type I collagen and anti-integrin-␤-1 activating antibody (P4G11) and analyzed with Western blotting. Colocalization was determined using immunofluorescence. Unilateral external carotid artery ligation was performed on heterozygous integrin-␤-1 knockout (Het-B1-KO) mice. Carotid arteries were examined on day 14 and jugular veins on days 1 and 7. Veins from Het-B1-KO mice were placed as aortic interposition grafts into wild-type mice and examined at day 21.Results: Endothelial cells stimulated with collagen or P4G11 increased Eph-B4 phosphorylation. Eph-B4 and integrin-␤-1 colocalized on both endothelial cells and wild-type Eph-B4 transfected Cos cells after stimulation with collagen; mutant W804A Eph-B4 transfected cells were unable to phosphorylate Eph-B4. Het-B1-KO mice that underwent unilateral ligation of the external carotid showed aberrant vascular remodeling. Het-B1-KO vein grafts showed approximately threefold increased neointimal thickening compared with wild-type controls.Conclusions: Integrin-␤-1 is present on endothelial cells, responds to hemodynamic forces, induces Eph-B4 signaling, and modifies vessel and vein graft remodeling. These results connect hemodynamic forces to vein graft adaptation through extracellular matrix interactions. Integrin-␤-1 is an upstream regulator of Eph-B4 signaling during vein graft adaptation and may represent a novel therapeutic target with the potential to limit neointimal hyperplasia in vein grafts.

AVF intervention can be performed safely and effectively under ultrasound guidance in the office setting and is a valuable tool in the management of dialysis access patients.