# Point of Care Elastographic Sonoangiography (eSA)

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

ABSTRACT
Our nation’s veterans are at a high risk for developing Chronic Kidney Disease (CKD) with rates of mortality and
morbidity that are extremely high. CKD progressing to End Stage Renal Disease (ESRD) is a disabling condition
resulting in patients requiring hemodialysis thrice weekly to maintain life. Functional independence on
hemodialysis requires a reliable and well-functioning vascular access to connect to the dialysis machine for
treatments. Vascular access is crucial to the treatments necessary for hemodialysis patients. Due to their
reliability, longevity, and lower complication rates, autogenous arteriovenous fistulas – surgically created
connections between arteries and veins – have become increasingly prominent over other forms of vascular
access. However, the uncertainty associated with fistula maturation has caused undue cost, risk, and stress to
patients already undergoing significant medical procedures. Furthermore, fistula dysfunction in the dialysis unit
impedes stable effective dialysis, creates undue psychological stress in patients, in addition to increasing the cost
of medical care. Currently no system exists to directly and noninvasively measure the underlying causes of
vascular remodeling during fistula maturation, or provides comprehensive diagnosis of fistula dysfunction at the
bedside. We propose to build and clinically validate an ultrasound diagnostic platform – referred to as the Point
of Care Elastographic Sono-Angiography (eSA) that has unprecedented temporal and spatial resolution to
identify vessel wall edges and measure vessel size, elastic properties, and blood-wall shear rate during the cardiac
cycles, and 3D mapping of the vascular anatomy at the point of care. After validating this tool both in vitro
(through phantom studies on simple and realistic fistula geometries) and in vivo (clinical study conducted on
hemodialysis patients pre- and post-fistula creation), we plan to release the software as an open platform tool
for researchers. This software tool will be useful for pre-operative planning and post-operative assessment to
guide decisions for angioplasty and surgical revision. Given the ubiquity and noninvasive nature of ultrasound
imaging and the broad open access with which we plan to release this tool, this proposal can radically accelerate
safe and effective ultrasound diagnostic methods for fistula optimization. In addition, given the generalizability
to other peripheral vascular systems (carotid, extremities) this system has the potential to optimize vascular
diagnostics and thereby improve the functional capacity of veterans suffering from peripheral and cerebral
arterial disease. By validating this technology in the dialysis fistula setting, this project will lay the foundation
for further clinical research applied to expanded clinical indications in vascular medicine in the future.

## Key facts

- **NIH application ID:** 10003854
- **Project number:** 5I01RX002271-04
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** William F Weitzel
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10003854

## Citation

> US National Institutes of Health, RePORTER application 10003854, Point of Care Elastographic Sonoangiography (eSA) (5I01RX002271-04). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10003854. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*