Week 10 – Why Do We Need Prosthetic Grafts Anyway?

July 3, 2019

I went back this past weekend to see what I’ve covered in the previous “Spin” of the Week blogs.  It is hard to believe it is already Week 10!  Week 1 seems like so long ago (memory begins to slip with age).  I hope that you’ve enjoyed the wide range of topics, from business and personal perspectives to providing an overview about some of our technology.  As I reviewed the different blogs, one thing that jumped out was I have not provided an explanation as to why would we need a device like our NuSpun Vascular Graft.  Like most things in life that you do a lot, you tend to forget that not everyone knows the background behind what you are doing.  I think most of us will admit to talking to people about what we do and seeing that blank distant gaze because they get lost from the get-go.  In science, this is especially true since most people have a fear of this topic to begin with.  Hopefully, I can alleviate this fear and give you a high-level understanding of why making an artificial artery (prosthetic graft) is important.

 

I discussed why grafts are typically used in Week 7.  This week I want to focus on two specific uses for these devices.    I think it is important to understand what diseases these devices are used to treat and how many people are affected.  People who suffer from atherosclerosis or “hardening of the arteries” need to re-route blood around a clogged artery.  When atherosclerosis occurs in the lower extremities, it is known as peripheral arterial disease (PAD).  There are many causes of atherosclerosis, from diabetes and smoking through diet and “unlucky” genetics.  The arteries in these patients accumulate cholesterol, clotted blood and other agents which narrows the “pipe”, reducing blood flow.  Sewing the prosthetic graft into the artery before and after the narrowing allows blood to go around the problem area.  PAD affects over 200 million people worldwide (most people have some degree of PAD but do not know it), with 10-20 million of these people not responding to medications and require surgery to restore blood flow to the lower part of the body (i.e. legs, feet).  Sadly, over 50% of patients diagnosed with End-Stage PAD will die within 5 years.  From a financial perspective, PAD expenditures for Medicare alone exceed $4.3 billion which is 6.8% of the total Medicare budget.         

 

The other use for prosthetic grafts is to treat patients with End-Stage Renal (Kidney) Disease or ESRD.  Kidneys in a healthy person act as a “wastewater treatment plant” in a sense, clearing all of the waste generated by cells in your body and allowing the clean blood to circulate back into the body to pick up more waste.  People who are healthy can live with one good kidney, which is pretty amazing.  That being said, kidneys can be damaged by a number of factors, similar to those that also cause atherosclerosis (also add uncontrolled high blood pressure to this list).  When waste cannot be removed from the body, a person will need external assistance in the form of hemodialysis (a blood-filtering system outside the body) or peritoneal dialysis (uses fluids injected into the abdomen that are used to remove waste). Over 90% of people with ESRD choose hemodialysis.  Patients who choose hemodialysis may need a prosthetic graft to physically connect an artery to a vein in order to withdraw blood from the body followed by blood infusion back into the body by puncturing the device with two needles.  There are over 2 million people worldwide that require hemodialysis.  In the US alone, there are over 450,000 people on hemodialysis, with over 110,000 new ESRD patients requiring hemodialysis.  You may wonder why the initial US patient numbers are not higher based on incoming new patients.  This is because 25% of existing hemodialysis patients will die each year, with a life expectancy once a patient starts hemodialysis of less than 5 years.  This is also the ONLY disease fully covered by Medicare.  Last year, the US government spent over $113 billion to treat ESRD patients, which is over 2% of the total US budget.

 

As you can see, there is such a huge need for improving prosthetic grafts in the fight to treat these diseases.  Current prosthetic grafts, while beneficial in some ways, have not improved in over 60 years in terms of complications associated with their use.  These complications result in more hospital stays, re-operations and sometimes death.  It is our mission to help people live better lives when afflicted with one of these diseases.  Time will tell if we possess one of the solutions.

 

Have a great 4th! 

 

Matt          

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