From fistula-first to patient-first

For hemodialysis patients, a "fistula first" approach has long been the standard. But fistulas can fail, 20 to 60 percent of the time,1-5 subjecting patients to undue hardship and central venous catheter (CVC)-related risks.

That's one reason 2019 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines6 emphasize the need for a more individualized approach to access modality selection.

It is about achieving the "right access, in the right patient, at the right time, for the right reasons."

- KDOQI guidelines

When patients are at risk for fistula non-maturation, turn to the GORE® ACUSEAL Vascular Graft – the purpose-built choice for rapid and long-term access for the road ahead. It is ideal for patients who are already on a CVC, or those who need a new access and must achieve cannulation in under two weeks.

It allows for earlier removal or avoidance of a CVC and helps achieve hemodialysis success with minimized access-related procedures and complications ─ for more confidence at every step.

24 hour Immediate Cannulation: Cannulate within 24 hours with the only FDA-cleared vascular access graft with the claim of immediate cannulation
Reduced infection and mortality: 5x lower risk of infection, compared with CVC; 3x lower risk of mortality, compared with CVC
Long-term access: 78% secondary patency demonstrated at 12 months.

Designed with your patients in mind

Because dialysis access is personal

The tri-layer design of the GORE® ACUSEAL Vascular Graft is optimized for early cannulation and provides uncompromised handling.

Image showing the tri-layer design of the GORE ACUSEAL Vascular Graft. Abluminal layer (ePTFE graft). Elastomeric layer. Luminal layer (ePTFE with CBAS Heparin Surface).
  • Purpose-built for immediate cannulation, designed with an elastomeric middle layer that serves as a low bleed barrier to cannulation needle holes.
  • Flexible at curves without kinking.

The GORE® ACUSEAL Vascular Graft also features CBAS Heparin Surface technology to resist thrombosis ─ a leading cause of AVG failure.11

Reported ability to significantly reduce early thrombosis rates. Reported potential to improve primary patency by up to 20%. 78% clot-free survival reported at one a year.

* Compared with non-immediate cannulation AV grafts.
Compared with standard non-heparin bonded ePTFE grafts.

  1. Allon M, Robbin ML. Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney International 2002;62(4):1109-1124.
  2. Allon M, Imrey PB, Cheung AK, et al; Hemodialysis Fistula Maturation (HFM) Study Group. Relationships between clinical processes and arteriovenous fistula cannulation and maturation: a multicenter prospective cohort study. American Journal of Kidney Diseases 2018;71(5):677-689.
  3. Dember LM, Beck GJ, Allon M, et al; Dialysis Access Consortium Study Group. Effect of Clopidogrel on early failure of arteriovenous fistulas for hemodialysis. A randomized controlled trial. Journal of the American Medical Association 2008;299(18):2164-2171.
  4. Allon M. Vascular access for hemodialysis patients: new data should guide decision making. Clinical Journal of the American Society of Nephrology 2019;14(6):954-961.
  5. Wish JB. Catheter last, fistula not-so-first. Journal of the American Society of Nephrology 2015;26(1):5-7.
  6. Lok CE, Huber TS, Lee T, et al; KDOQI Vascular Access Guideline Work Group. KDOQI Clinical Practice Guideline for Vascular Access: 2019 update. American Journal of Kidney Diseases 2020;75(4)Supplement 2:S1-S164.
  7. Marketrack: PriceTrack Database. Burlington, MA: Decision Resources Group; 2015 https://decisionresourcesgroup.com/. Accessed August 14, 2017.
  8. Aitken E, Thomson P, Bainbridge L, Kasthuri R, Mohr B, Kingsmore D. A randomized controlled trial and cost-effectiveness analysis of early cannulation arteriovenous grafts versus tunneled central venous catheters in patients requiring urgent vascular access for hemodialysis. Journal of Vascular Surgery 2017;65(3):766-774.
  9. Glickman M. Early cannulation graft: Acuseal. Journal of Vascular Access 2016;17 (Supplement 1):S72-S74.
  10.   Mohr BA, Trovillion PJ. Economic value of preventing central venous catheter sepsis infections with early cannulation arteriovenous grafts (ECAVGS) compared to non-ecavgs. Presented at the ISPOR 20TH Annual International Meeting; May 16-20, 2015; Philadelphia, PA. Value in Health 2015;18(3):A42 PMD27.
  11.   Roy-Chaudhury P, Kelly BS, Melhem M, et al. Vascular access in hemodialysis: issues, management, and emerging concepts. Clinical Cardiology. 2005;23:249-273.
  12.   Shemesh D, Goldin I, Hijazi J, et al. A prospective randomized study of heparin-bonded graft (Propaten) versus standard graft in prosthetic arteriovenous access. Journal of Vascular Surgery 2015 Jul;62(1)115-22. doi:10.1016/j.jvs.2015.01.056. Epub 2015 Mar12. PMID: 25770987.
  13.   Davidson I, Hackerman C, Kapadia A, Minhajuddib A. Heparin bonded hemodialysis e-PTFE graft result in 20% clot free survival benefit. Journal of Vascular Access 2009 Jul-Sep;10(3):153-6. doi: 10.1177/112972980901000303. PMID:19670166.

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