Business Excellence: How Vertical Integration Puts the “Hero” in HeRO® Graft
At Merit, we incorporate additional value into every interaction across our organization. This means prioritizing business excellence each step of the way. From innovating high-quality products to providing exceptional customer service, we go above and beyond to show our healthcare partners our commitment to ongoing superior performance.
One aspect of our business excellence strategy is incorporating vertical integration into our processes wherever possible. Merit strives to own the company supply chain to minimize disruptions, maintain closer control over operations, and ultimately, ensure product reaches physicians to serve patients—when they need it.
We sat down with John Hall, Executive VP of Advanced Materials Technologies at Merit, to chat about how moving the process of making ePTFE in-house helps us supply physicians with the HeRO® Graft.
To help our readers understand, what is ePTFE and how is it used in medical products?
EPTFE, or expanded polytetrafluoroethylene, acts like the material of a rain jacket. It allows water vapor to pass through while remaining resistant to liquid water. The result is a breathable, tightly porous product.
Researchers discovered that ePTFE is also an excellent replacement for blood vessels in the body, as it’s inert and biocompatible. This ensures it can be implanted without significant inflammatory response. For these reasons, ePTFE is used to increase the performance of several Merit products, including the HeRO Graft.
What role does the HeRO Graft serve in treating patients?
The HeRO Graft provides hemodialysis access for patients with renal disease who are catheter-dependent or approaching catheter dependency due to the blockage of veins leading to the heart.
These patients deserve comfort and convenience to live their lives to the fullest. The HeRO Graft helps by reducing infection and improving dialysis adequacy. Because the HeRO Graft is implanted inside the body, it requires a material like ePTFE to be biocompatible.
Why did Merit decide to vertically integrate the production of ePTFE?
Six or seven years ago, we were outsourcing our supply of ePTFE through another company. Merit’s Chairman and CEO, Fred Lampropoulos, envisioned bringing production in-house in the event that supply chain disruptions interfere with our ability to provide this important product to patients in need.
As it turns out, during the process of starting our own production of the material, we did face a disruption. Thankfully, due to Fred’s foresight, we were able to continue manufacturing the HeRO Graft and other products using ePTFE.
Quality control was another major factor in our decision. When we’re the ones creating the material, we can more closely monitor output, helping to produce a superior product for patients.
How does this benefit our healthcare partners and their patients?
Bringing this process in-house allows us to deliver our products in a timelier manner—critical when you’re in the business of saving lives.
Producing our own ePTFE also allows us to innovate other products where the material could benefit the patient experience.
Discover more of our business excellence strategies, and learn how else we put our healthcare partners and their patients first.
The Making of Merit Medical—A Timeline Celebrating 35 Years
This year, we’re celebrating 35 years of Merit Medical, an organization founded with a vision to be the most customer-focused company in healthcare. Since then, we’ve expanded from our headquarters in Salt Lake City, UT, to facilities across the world with a diverse, ever-growing portfolio of products.
As with any great business, we couldn’t have done it alone. Our team is at the heart of what we do. We understand clinician needs and innovate products to meet those needs. We deliver diagnostic and treatment solutions that work. Above all, we help ensure our healthcare partners have what they need to help patients live their best lives.
Let’s look back at some of the pivotal moments that made us Merit.
1987
Our story begins more than three decades ago in an industrial park in Murray, UT. Fred Lampropoulos, Merit’s founder and CEO, brought his idea of a stronger, safer, disposable syringe to life—replacing glass syringes currently used in patient care. In 1988, our first syringe hit the market, paving the way for countless medical innovations to come.
1994
To keep up with an increasing demand for our growing portfolio, we opened our first international location, a manufacturing facility in Galway, Ireland. Today, our Galway team continues to thrive. In 2018, they earned the Medtech Company of the Year award in recognition of their dedication.
This same year, we also saw the opening of Merit Sensor, one of several product divisions that bolster our offerings.
1999
This year marked the opening of our Merit Houston facility. A Center of Excellence, Merit Houston specializes in polymer extrusions and catheter manufacturing.
![ReSolve® Biliary Locking Drainage Catheter [Introduction]](https://meritlegacy.decort.co/wp-content/uploads/2021/11/2021-11-23_12-22.png)
2000
More than a decade of focus and persistence came to fruition in 2000 with the launch of our first compression device, the RADstat® Radial Artery Compression Device. Since then, we’ve continuously innovated and improved our compression device offerings to provide clinicians with superior options—the PreludeSYNC EZ™, PreludeSYNC DISTAL™, and SafeGuard® family of products.
2004
As our US presence continued to grow, we added another location through the acquisition of our Richmond, VA, facility. An integral part of our business, it remains an important manufacturing and distribution center, responsible for producing more than 35 million components each year.
2005
Close to home and far away, this year brought big developments. Our Salt Lake headquarters opened a new manufacturing facility. Doubling its existing square footage, the new facility added more than one hundred new production jobs.
We also opened a facility in Venlo, Netherlands, specializing in manufacturing coated wires, and in 2008, followed with a sister location in Maastricht, our EMEA Distribution Center of Excellence.
2010
In 2010, we opened our Paris facility. This expansion gave us state-of-the-art embolic material manufacturing capabilities. Our global capacity for delivering more minimally invasive treatment options to patients increased.
2015
Our Tijuana, Mexico, facility opened in 2015, where our dedicated employees enjoy award-winning cafeteria service, a safe and convenient transportation system, and more. As one of our primary manufacturing and assembly facilities, our Tijuana team plays a critical role in our success.
2016
In 2016, we launched the SCOUT® Radar Localization system. Designed to improve patient outcomes, SCOUT marked our strong commitment to reducing the burden breast cancer has on patients and their loved ones. As of 2021, SCOUT surpassed 200,000 procedures worldwide.
As the company expanded, we were able to show our appreciation for employees by offering more services that prioritized their health and wellness. This year Merit Salt Lake introduced the Merit Care Clinic, an on-site practice that provides low-cost healthcare to employees and their dependents. We also opened the Merit Employee Garden, a 1-acre parcel of land that offers fresh produce as well as the opportunity for our team to spend time outdoors.
2017
We were proud to welcome Singapore to our Merit family in 2017 as one of our chief centers for innovating and manufacturing. Our Singapore team has more than 30 years of experience in Critical Care product development; and with its R&D laboratory capabilities, it closely collaborates with government agencies and research institutes.
2022
Today, Merit is a billion-dollar company that continues to have a positive impact on patient lives worldwide. Our family of 6,800 employees make this possible by fulfilling the Merit mission to Understand, Innovate, and Deliver.
To our dedicated team, thank you for your efforts in building the next great healthcare company. We look forward to many more years of making a difference.
What To Expect from Merit at SIR 2022 – “Advanced Outcomes Made Simple”
Merit will be exhibiting at SIR 2022, the Society of Interventional Radiology’s Annual Scientific Meeting. Join us June 12 – 14 in Boston, MA, for a high-quality educational program with an international audience, in-person training, and hands-on workshops. Along with showcasing an exciting lineup of leading-edge products, this year we’re hosting a Lunch & Learn session you won’t want to miss.
Here’s a sneak peek of what you can expect at booth #418:
LUNCH & LEARN
Lunch is on us! We hope to see you Monday, June 13 at 12:00 PM EDT for the following educational presentation:
Case-Based Discussion of Steerable Technology in Treatment of VCF and Spinal Metastatic Disease
DATE: Monday, June 13
TIME: 12:00 pm EDT
WHERE: Booth #418
LEARNING OBJECTIVES:
- Understand Clinical & Procedural Value of Steerable Devices
- Discover Therapy-Awareness Strategies
- Engage in Case-Based Discussion and Q&A
FACULTY
Dana Dunleavy, M.D.
Windsong Radiology Director of Interventional & Vascular Services
Buffalo, NY
Learn more about Dr. Dunleavy
PRODUCT SHOWCASE AT BOOTH #418
NEW Prelude Roadster™ Guide Sheath
Expand your diagnostic and interventional procedures with the new Prelude Roadster, a longer guide sheath designed to access difficult anatomy in the peripheral vasculature. Stop by booth #418 to be among the first to discover this brand-new technology.
ReSolve® Thoracostomy Tray
The ReSolve Thoracostomy Tray allows air (pneumothorax) and fluid (pleural effusion) to be drained from the pleural space through a percutaneous approach rather than an open surgical approach, providing your patients with minimally invasive care.
TEMNO Elite™ Biopsy System
The TEMNO Elite Biopsy System offers the reliability you expect with new features designed to provide superior soft tissue samples and total procedure control.
SplashWire™ Hydrophilic Steerable Guide Wire
The Merit SplashWire combines optimum lubricity, exceptional torque response, and enhanced visibility, helping you achieve the successful outcomes you expect for your patients. We designed the SplashWire to successfully perform in the most complex cases.
ReSolve ConvertX® Nephroureteral & Biliary Stent System
Drain to stent in 30 seconds1 with the ConvertX. Designed to treat ureteral and biliary obstructions, you can place it like any internal-external drain, then convert it to a stent when you’re ready.
Surfacer® Inside-Out® Access Catheter System
Pioneered by interventional cardiologist John Gurley, M.D., the Inside-Out approach was developed in response to patients with chronically occluded veins that required life-saving vascular access. Inserted in the femoral vein, the Surfacer Inside-Out Access Catheter System locates an exit from the right internal jugular vein, maintaining viable secondary veins if necessary.
See the Surfacer featured on the cover of June 2022 Journal of Vascular Surgery.
One-Vac™ Evacuated Drainage Bottle
Engineered with an advanced design, the One-Vac is the smart option when choosing an evacuated drainage bottle. Built with a number of key features, the One-Vac makes percutaneous fluid collection and discard simple, efficient, and safe for you and your patients.
EmboCube® Embolization Gelatin
Specifically designed for embolization of hypervascular tumors and blood vessels to occlude blood flow, EmboCube controls hemorrhaging in the peripheral vasculature. Gelatin is cut uniformly in preloaded 1-mL or 3-mL Medallion® Syringes to help ensure seamless prep and accurate delivery.
Embosphere® Microspheres
The most clinically studied spherical embolic, Embosphere is the clear choice among interventional radiologists. Designed for predictable and durable occlusion for the embolization of symptomatic uterine fibroids, AVMs, and hypervascular tumors, the elastic material allows for temporary compression of up to 33%3, yielding targeted results for patients and practitioners.
Merit Maestro® Microcatheters
A multipurpose microcatheter, the Maestro is designed to deploy coils up to 0.018″ and embolics up to and including 900 µm. A swan neck design helps you seat the catheter in the vessel, reducing the recoiling effect.
SwiftNINJA® Steerable Microcatheter
The SwiftNINJA is an innovative straight-tip catheter featuring an ergonomic steering dial that navigates up to 180 degrees and enables in vivo control. Consisting of a hydrophilic-coated distal 80 cm, the device delivers exceptional precision and speed even when you’re navigating the most challenging vascular ostium.
Prelude IDeal™ Hydrophilic Sheath Introducer
A hydrophilic access sheath with increased kink and compression resistance makes the IDeal the tool of choice for your radial access procedures.
Arcadia™ Steerable Balloon-Assisted Vertebral Augmentation
The Arcadia is designed to achieve controlled, precise, targeted cavity creation in your vertebral augmentation procedures—whether your approach is unipedicular or bipedicular.
NEW AT MERIT: Arcadia™ Curved Delivery Cannula
Stop by booth #418 and ask us about our NEW Arcadia™ Curved Delivery Cannula—a bone cement delivery system designed for predicable cement deposition across the midline of the vertebral body, optimizing cement volume, while potentially reducing the need for bipedicular access.
STAR™ Tumor Ablation System
STAR delivers meaningful pain relief and localized tumor destruction in a single treatment. Your patients will appreciate that this mechanism is designed to perform successfully and comfortably in an outpatient setting.
We look forward to seeing you at SIR 2022 and discussing all the ways we can help you enhance your patient care. Questions? Contact our Customer Support team and speak to one of our representatives. Live chat, phone, or email—we are here for you.
Don’t forget to follow us on social media for live conference updates!
Before using any of the Merit products mentioned above, refer to Instructions for Use for indications, contraindications, warnings, precautions, and directions for use.
REFERENCES
- Data on File.
- Laurent et al. Am J Neuroradial 1996.
Join Merit Medical for Hands-on Workshops at the European Vascular Course 2022
Merit will be exhibiting at the European Vascular Course, held from 12 – 14 June in Maastricht. The course will celebrate its 25th anniversary and will comprise more than 300 workshops. 
Our team will be showcasing cutting-edge technologies and hosting seven experiential hands-on workshops. Please register for our workshop program via www.vascular-course.com. We look forward to seeing you in person at booth #28 and training room #2.4!
Check out what the Merit team has in store for attendees:
PHYSICIAN EDUCATION
Serious Challenges in the Dialysis Access Circuit: What Treatment Options Would You Choose and Why?
Course Option 1:
- DATE: Sunday, 12 June
- TIME: 16:30 – 18:00 CEST
Course Option 2:
- DATE: Tuesday, 14 June
- TIME: 09:00 – 10:30 CEST
Faculty:
- Mr. James Gilbert, Transplant & Vascular Access Surgeon, Oxford, UK
Learning Objectives:
- Understand development in dialysis access
- Provide options in complex, unusual, and desperate access situations
- Learn treatment and patient algorithm
- Increase knowledge and skill set on the use of the Merit WRAPSODY™ Cell-Impermeable Endoprosthesis, HeRO® Graft, and Surfacer® Inside-Out® procedures
Attendees: This training session is designed for physicians with an interest in difficult ESRD access with patients who have central venous stenosis and central venous occlusion: vascular surgeons, interventional radiologists, and nephrologists.
Merit WRAPSODY Cell-Impermeable Endoprosthesis
HeRO Graft
Surfacer Inside-Out Access Catheter System
How Low Can You Go? Benefits of Treating to the Lowest Point of Incompetence.
Course Option 1:
- DATE: Sunday, 12 June
- TIME: 10:00 – 11:00 CEST
Course Option 2:
- DATE: Monday, 13 June
- TIME: 16:00 – 17:00 CEST
Faculty:
- Mr. Leith Williams, Vascular Surgeon, Wirral, UK
Learning Objectives:
- Understand the benefits of treating advanced venous disease with non-thermal, non-tumescent (NTNT) technique
- Learn an innovative approach to treat VLU
- Experience a practical approach to the ClariVein® OC device and the procedure
Attendees: This training session is designed for physicians with an interest in chronic venous insufficiency and phlebology: vascular surgeons, interventional radiologists, phlebologists, angiologists, dermatologists, and physician associates.
Tackle Common Procedural Challenges: Wires, Catheters, and Snares—Which Are the Best Options?
Course:
- DATE: Sunday, 12 June
- TIME: 13:00 – 14:30 CEST
Faculty:
- The Merit Education Team
Learning Objectives:
- Learn the basics of diagnostic wires, catheters, and snares
- Understand how to differentiate between Teflon wires and hydrophilic wires
- Explore how to cannulate visceral and cerebral vessels by using different wires and catheters as well as the removal of foreign objects
Attendees: This training session is designed for residents with an interest in interventional radiology.
Distal First? What’s New in Transradial Access.
Course:
- DATE: Monday, 13 June
- TIME: 12:00 – 13:30 CEST
Faculty:
- The Merit Education Team
Learning Objectives:
- Understand proximal and distal radial access as well as how it impacts practices
- Learn ultrasound access techniques with POV instruction, haemostasis, and avoid common pitfalls
- Comprehend case selection and patient prep workflow
Attendees: This training session is designed for physicians with an interest in radial and distal radial access: interventional cardiologists, interventional radiologists, neurointerventional radiologists, and interventional nephrologists.
Vascular Access Nurse—What Is the Latest ESRD Access That Can Benefit Patients with Failing Fistulas and Grafts?
Course:
- DATE: Monday, 13 June
- TIME: 09:20 – 11:00 CEST
Faculty:
- The Merit Education Team
Learning Objectives:
- Understand development in dialysis access
- Support vascular wellness best practice
- Improve vascular access care for patients
Attendees: This training session is designed for nurses with an interest in difficult ESRD access with patients who have central venous stenosis and central venous occlusion.
PRODUCT SHOWCASE AT BOOTH 28
HeRO® Graft
The HeRO Graft, a hemodialysis access graft designed for catheter-dependent patients or those failing fistulas or other grafts, offers a 69% reduction in future infections compared to patients receiving catheters as well as a cost-saving of 23% on average per year.
Surfacer® Inside-Out® Access Catheter System
Surfacer® Inside-Out® Access Catheter SystemPioneered by interventional cardiologist John Gurley, M.D., the Inside-Out approach was developed in response to patients with chronically occluded veins that required life-saving vascular access. Inserted in the femoral vein, the Surfacer® Inside-Out® Access Catheter System locates an exit from the right internal jugular vein, maintaining viable secondary veins if necessary.
See the Surfacer featured on the cover of June 2022 Journal of Vascular Surgery.
Merit WRAPSODY™ Cell-Impermeable Endoprosthesis
Featuring a unique tri-layered endoprosthesis microstructure, the Merit WRAPSODY Cell-Impermeable Endoprosthesis extends long-term vessel patency in patients who experience obstructions in the dialysis outflow circuit. The hydrophilic coating allows pinpoint accuracy, smooth insertion, and withdrawal with top-tier trackability.
Please Note: The Merit WRAPSODY Cell-Impermeable Endoprosthesis is not available for sale or use within the United States.
ClariVein® OC Infusion Catheter
ClariVein® OC Infusion CatheterA minimally invasive solution for patients, the ClariVein® OC Infusion Catheter features a unique 360-degree rotatable dispersion wire at the distal end. The catheter design has been engineered with a small profile, exceptional flexibility, strong imaging visualization, and excellent pushability.
Please Note: The ClariVein OC Infusion Catheter is not available for sale or use within the United States.
Merit MAK™ Mini Access Kit
Merit MAK™ Mini Access KitTo access the vascular system, Merit MAK Mini Access Kits take a very small approach, minimizing bleeding and trauma for the patient. Merit MAK guide wires are carefully engineered with a fully enclosed hoop and available in several configurations. Each kit includes a coaxial introducer/dilator pair, 21G needle, and guide wire.
Merit is committed to offering healthcare professionals the technologies and education opportunities they need to improve patient care. We are proud to participate in EVC 2022 and look forward to seeing you in person. Register for EVC and all workshops at www.vascular-course.com.
Merit WRAPSODY™ Endoprosthesis and ClariVein® OC are not approved or available for sale in the United States.
Before using any of the Merit products mentioned above, refer to Instructions for Use for indications, contraindications, warnings, precautions, and directions for use.
REFERENCES
- Katzman et al., J Vasc Surg 2009.
- Dageforde et al., JSR 2012.
Join Merit Medical for Educational Sessions and Live Case Transmission at LINC 2022
We look forward to attending the Leipzig Interventional Course (LINC), held from 6 to 9 June, in person and online. Our team will be hosting a satellite symposium with live case transmission and several on-demand learning centre sessions. Attendees can also visit Merit booth #39 to explore multiple product innovations.
Mark your calendars—here’s an outline of what we have planned:
SATELLITE SYMPOSIUM
DATE: Monday, 6 June
TIME: 15:50 – 17:05 CEST
WHERE: Main Arena 2 & Online
LEARNING OBJECTIVES
- Follow an overview on the evolution of covered stents
- Learn more about the current WRAPSODY trial pipeline (FIRST, IDE, and Registry)
- Understand how to manage patients and how to decide their best treatment options (i.e., treatment algorithm)
- Discover how the WRAPSODY can be beneficial and cost effective in daily treatment
AGENDA
| TIME | DESCRIPTION | FACULTY |
| 15:50 – 15:53 | Introduction by the moderator | Prof. Dr. Fabrizio Fanelli |
| 15:53 – 16:04 | The evolution of covered stents | Dr. Tobias Steinke |
| 16:04 – 16:16 | Live case transmission from Varese University of Insubria | Prof. Dr. Matteo Tozzi |
| 16:16 – 16:27 | Clinical trials: WRAPSODY FIRST, IDE, and Registry | Prof. Dr. Dheeraj Rajan |
| 16:27 – 16:39 | Recorded case presentation | Dr. Tobias Steinke |
| 16:39 – 16:50 | The algorithm for covered stent treatment | Dr. Ounali Jaffer |
| 16:50 – 17:00 | Health economics in covered stent management: An overview | Prof. Katarzyna Kolasa |
| 17:00 – 17:05 | Final Q&A and wrap-up |
LEARNING CENTRE SESSIONS
CENTRE 1
Rethinking AVF Management: WRAPSODY, the Cell-Impermeable Endoprosthesis in Challenging AV Access Repair
Faculty:
– Dr. Tobias Steinke, Vascular Surgeon, Schön Klinik, Dusseldorf, Germany
– Dr. Andrew Wigham, Interventional Radiologist, Churchill Hospital, Oxford, United Kingdom
CENTRE 2
Transradial TACE with HepaSphere™ Microspheres: A Journey from Patient Selection to Outcome
Faculty:
– Dr. Darren Klass, Clinical Associate Professor, University of British Columbia, Vancouver, Canada; Consultant Radiologist, Cleveland Clinic, London, United Kingdom
CENTRE 3
ClariVein® OC Procedural Video
Faculty:
– Mr. Leith Williams, Vascular Surgeon, Wirral, United Kingdom
PRODUCT SHOWCASE IN BOOTH 39
HeRO® Graft
The HeRO Graft, a hemodialysis access graft designed for catheter-dependent patients or those failing fistulas or other grafts, offers a 69% reduction in future infections compared to patients receiving catheters as well as a cost-saving of 23% on average per year.
Surfacer® Inside-Out® Access Catheter System
Pioneered by interventional cardiologist John Gurley, M.D., the Inside-Out approach was developed in response to patients with chronically occluded veins that required life-saving vascular access. Inserted in the femoral vein, the Surfacer® Inside-Out® Access Catheter System locates an exit from the right internal jugular vein, maintaining viable secondary veins if necessary.
See the Surfacer featured on the cover of June 2022 Journal of Vascular Surgery.
Merit WRAPSODY™ Cell-Impermeable Endoprosthesis
Featuring a unique tri-layered endoprosthesis microstructure, the Merit WRAPSODY Cell-Impermeable Endoprosthesis extends long-term vessel patency in patients who experience obstructions in the dialysis outflow circuit. The hydrophilic coating allows pinpoint accuracy, smooth insertion, and withdrawal with top-tier trackability.
Please Note: The Merit WRAPSODY Cell-Impermeable Endoprosthesis is not available for sale or use within the United States.
ClariVein® OC Infusion Catheter
A minimally invasive solution for patients, the ClariVein® OC Infusion Catheter features a unique 360-degree rotatable dispersion wire at the distal end. The catheter design has been engineered with a small profile, exceptional flexibility, strong imaging visualization, and excellent pushability.
Please Note: The ClariVein OC Infusion Catheter is not available for sale or use within the United States.
Merit MAK™ Mini Access Kit
To access the vascular system, Merit MAK Mini Access Kits take a very small approach, minimizing bleeding and trauma for the patient. Merit MAK guide wires are carefully engineered with a fully enclosed hoop and available in several configurations. Each kit includes a coaxial introducer/dilator pair, 21G needle, and guide wire.
Embosphere® Microspheres
Embosphere® MicrospheresThe most clinically studied spherical embolic, Embosphere is the clear choice among interventional radiologists. Designed for predictable and durable occlusion for the embolisation of symptomatic uterine fibroids, ABMs, and hypervascular tumours, the elastic material allows for temporary compression of up to 33%,3 yielding targeted results for patients and practitioners.
EmboCube® Embolization Gelatin
EmboCube® Embolization GelatinSpecifically designed for embolisation of hypervascular tumours and blood vessels to occlude blood flow, EmboCube consistently controls haemorrhaging in the peripheral vasculature. Gelatin is cut uniformly in preloaded 1-mL or 3-mL Medallion® Syringes to help ensure seamless prep and accurate delivery.
SwiftNINJA® Steerable Microcatheter
The SwiftNINJA is an innovative straight-tip catheter featuring an ergonomic steering dial that navigates up to 180 degrees and enables in vivo control. Consisting of a hydrophilic-coated distal 80 cm, the device delivers exceptional precision and speed navigating even in the most challenging vascular ostium.
We look forward to seeing you at LINC 2022 and presenting all the ways we can partner with you for better patient care. Questions? Contact our Customer Support team and speak to one of our representatives via live chat, phone, or email.
Merit WRAPSODY™ Endoprosthesis and ClariVein® OC are not approved or available for sale in the United States.
Before using any of the Merit products mentioned above, refer to Instructions for Use for indications, contraindications, warnings, precautions, and directions for use.
REFERENCES
- Katzman et al., J Vasc Surg 2009.
- Dageforde et al., JSR 2012.
- Laurent et al. Am J Neuroradial 1996.
Merit Medical to Showcase Innovative Products and Participate in Hands-on Workshops at Charing Cross 2022
Merit will be exhibiting at this year’s Charing Cross International Symposium 2022, “the leading vascular symposium where Education, Innovation, and Evidence come together.” 
This year’s symposium will be offered in-person in London and virtually 26-28 April. Merit is hosting two experiential hands-on workshops and two interactive physician education opportunities.
Find us at booth #16 where we’ll be showcasing the following products:
PRODUCT SHOWCASE
HeRO® Graft
The HeRO Graft, a hemodialysis access graft designed for catheter-dependent patients or those failing fistulas or other grafts, offers a 69% reduction in future infections compared to patients receiving catheters as well as a cost-saving of 23% on average per year.
Surfacer® Inside-Out® Access Catheter System
Pioneered by interventional cardiologist John Gurley, M.D., the Inside-Out approach was developed in response to patients with chronically occluded veins that required life-saving vascular access. Inserted in the femoral vein, the Surfacer® Inside-Out® Access Catheter System locates an exit from the right internal jugular vein, maintaining viable secondary veins if necessary.
Merit WRAPSODY™ Cell-Impermeable Endoprosthesis
Featuring a unique tri-layered endoprosthesis microstructure, the Merit WRAPSODY Cell-Impermeable Endoprosthesis extends long-term vessel patency in patients who experience obstructions in the dialysis outflow circuit. The hydrophilic coating allows pinpoint accuracy, smooth insertion, and withdrawal with top-tier trackability.
Please Note: The Merit WRAPSODY Cell-Impermeable Endoprosthesis is not available for sale or use within the United States.
ClariVein® OC Infusion Catheter
A minimally invasive solution for patients, the ClariVein® OC Infusion Catheter features a unique 360-degree rotatable dispersion wire at the distal end. The catheter design has been engineered with a small profile, exceptional flexibility, strong imaging visualization, and excellent pushability.
Please Note: The ClariVein OC Infusion Catheter is not available for sale or use within the United States.
Merit MAK™ Mini Access Kit
To access the vascular system, Merit MAK Mini Access Kits take a very small approach, minimizing bleeding and trauma for the patient. Merit MAK guide wires are carefully engineered with a fully enclosed hoop and available in several configurations. Each kit includes a coaxial introducer/dilator pair, 21G needle, and guide wire.
PHYSICIAN EDUCATION
Edited Case: How to Treat Venous Leg Ulcers Efficiently.
How Low Can You Go?
Faculty: Mr. Leith Williams
Date: Tuesday, 26 April
Time: 16:50-16:55 BST
Location: Kensington 2, Venous and Lymphatic Challenges
Learning Objectives:
• Understand the benefits of treating advanced venous disease with the ClariVein OC/NTNT technique.
• Receive an update of evidence and guidance on the treatment of venous leg ulcers
• Learn a practical approach to the ClariVein OC device and procedure
Satellite Symposium: When to Stent? Which Stent?
Continuing Experience with the WRAPSODY Cell-Impermeable Endoprosthesis
Faculty: Dr. Andrew Wigham, Dr. Ounali Jaffer, and Dr. Robert Jones
Date: Wednesday, 27 April
Time: 10:00-10:30 AM BST
Location: Richmond, Vascular Access Masterclass
Learning Objectives:
• Understand how to manage patients and how to decide their best treatment options (i.e., treatment algorithm)
• Know more about the current WRAPSODY trial pipeline (FIRST, IDE, and Registry)
• Learn how WRAPSODY can be beneficial and cost effective in daily treatment
HANDS-ON WORKSHOPS
Hands-on Vascular Access Workstation with the Merit WRAPSODY, HeRO Graft, and Surfacer
Faculty: Mr. Gilbert
Date: Tuesday, 26 April
Time: 10:00-15:00 BST
Location: Workshop Wing
Hands-on Venous Workstation with the ClariVein OC and Merit MAK Mini Access Kit
Faculty: Mr. Williams
Date: Wednesday, 27 April
Time: 09:30-15:30 BST
Location: Workshop Wing
At Merit Medical, we are equally dedicated to cutting-edge innovation with our medical products and physician education. Merit is proud to participate in Charing Cross 2022, and we look forward to seeing you in person or virtually!
Merit WRAPSODY™ Endoprosthesis and ClariVein® OC are not approved or available for sale in the United States.
Before using any of the Merit products mentioned above, refer to Instructions for Use for indications, contraindications, warnings, precautions, and directions for use.
Merit Medical Recognizes National Kidney Month
March is National Kidney Month, and Merit Medical is committed to empowering the health and wellness of people living with chronic kidney disease and their caregivers. At Merit, our goal is to support the renal health community through a vast array of state-of-the-art therapeutic products, physician education courses, and patient education tools that equip clinicians to make a difference for people living with chronic kidney disease.
According to the National Institutes of Health, approximately 37 million Americans live with chronic kidney disease.1 Although incidences of chronic kidney disease have risen consistently, 9 out of 10 people are not aware of their diagnosis because early-stage kidney disease generally has no symptoms.1
The U.S. Renal Data System 2020 Annual Report cited that approximately 786,000 Americans live with end-stage renal or kidney disease, with 71% (558,000) of those receiving dialysis and 29% (228,000) receiving a kidney transplant.2 People living with end-stage kidney disease require dialysis therapy to regulate body functions, including controlling blood pressure, because their kidneys no longer can.3 Without access to adequate, regular, and affordable dialysis care, people living with end-stage kidney disease will not survive.3
As the number of people impacted by kidney disease continues to increase, Merit’s significant commitment to the renal health community is crucial. Merit is uniquely positioned with hemodialysis and peritoneal dialysis (PD) options for treatments and ancillary products that make a difference for dialysis patients who depend on high-quality care.
Merit Products
Super HeRO®
The Super HeRO Adapter and Support Seal system equips surgeons with standard wall and early cannulation vascular graft options. In addition to reducing hospital admissions due to catheter infections, the Super HeRO helps hospitals and dialysis centers save $3,100 per patient per year when converting catheter-dependent patients to the HeRO graft.
HeRO Graft®
For catheter-dependent patients, or those whose kidney function fails to improve with fistulas or grafts, Merit has engineered a solution: the HeRO Graft, a hemodialysis access graft designed precisely for these patients. Research indicated a 69% reduction in future infections with the HeRO Graft compared to patients receiving catheters.
Surfacer® Inside-Out® Access Catheter System
The Inside-Out approach was developed by John Gurley, M.D., in response to patients with chronically occluded veins. The Surfacer Inside-Out Access Catheter System is inserted through the femoral vein and navigated to an exit point in the right internal jugular vein, preserving the viability of secondary central veins.
Peritoneal Dialysis Catheters
To improve flow rates by 30%, Merit designed Flex-Neck Peritoneal Dialysis Catheters with an internal diameter (ID) that is 35% larger than competitors. Infant catheters come in one and two cuff configurations, and each catheter kit has a unique stenciling system for improved placement accuracy.
CentrosFlo® Hemodialysis Catheters
Featuring self-centering curved tips to promote optimal blood flow and minimize recirculation rates, The Centros (without side holes) and the CentrosFLO™ (with side holes) long-term hemodialysis catheters reach the pinnacle of overall catheter performance. Designed by Dr. Stephen Ash, Merit’s 15F catheters feature a large internal lumen, promoting a flow rate up to 450 mL/minutes.
ProGuide™ Chronic Dialysis Catheters
Designed for patient comfort, ease of insertion, and maintenance, ProGuide Chronic Dialysis Catheters are inserted through a valved peel-away sheath or over-the-wire placements and available in catheter lengths from 19 cm to 50 cm (tip to cuff). Available configurations include standalone catheter, basic kit, complete kit, and complete kit with mini access kit.
Physicians and surgeons look to Merit to provide insightful resources and cutting-edge therapeutic products designed to make a difference for people living with chronic kidney disease. Merit designs and innovates leading products specifically for patients receiving dialysis. For more information on how you can incorporate our dialysis products into your practice, please contact Merit Customer Support.
REFERENCES
- National Institutes of Health. National Kidney Month 2022. Retrieved from https://www.niddk.nih.gov/health-information/community-health-outreach/national-kidney-month
- American Society of Nephrology. (April 2021). Dialysis Care Around The World: A Global Perspective. Retrieved from https://kidney360.asnjournals.org/content/2/4/604
- National Kidney Foundation. Dialysis Info. Retrieved from https://www.kidney.org/atoz/content/dialysisinfo
What’s Your Clinical Challenge? We Have a Solution.
As a leader in customer-focused healthcare, Merit Medical’s priority is to ensure that you have the tools you need to care for your patients. Ranging from product kits to education opportunities, our Complete Solutions simplify preparation and streamline procedures to support quality patient care with a trusted, innovative range of medical devices.
CARDIAC CATHETERIZATION
Our cardiac catheterization solutions provide you with a variety of tools to help you accurately diagnose and successfully treat patients with heart problems. From sheath introducers, like our Prelude IDeal™, and guide wires to catheters, inflation devices, and more, we offer a number of superior devices for your procedures.
CRITICAL CARE
When treating vulnerable patients, every product you use matters. We offer a broad spectrum of tools designed for patients being treated in the critical care unit. Merit critical care technologies aim to reduce contaminant exposure, accurately monitor patient blood pressure, and decrease workplace injury, helping you provide treatment that is safe, effective, and efficient.
DIALYSIS ACCESS
Kidney disease is a global issue, and access is the foundation for any successful dialysis procedure. Our comprehensive dialysis access portfolio, including our catheter-dependence reducing HeRO® Graft, brings reliable and innovative solutions to your practice.
PERITONEAL DIALYSIS
Our home dialysis options offer several patient advantages over in-center dialysis, including better kidney disease-related quality of life. We offer virtual and hands-on physician training, a wide range of catheter sizes, accessories, kits, and patient resources.
RADIAL
Radial access has many well-documented benefits that include improved patient safety, a significant reduction in cost of care, and increased patient and staff satisfaction. We support radial access with a diverse portfolio of innovative products and a world-renowned hands-on physician education program, helping you offer the advantages of radial to your patients.
DISTAL RADIAL ACCESS
Distal radial artery access offers both patient and operator advantages. To help bring these benefits to your practice, we provide advanced training on the distal technique as well as innovative products to support your procedures, such as the first-to-market PreludeSYNC DISTAL™ Radial Compression Device.
DRAINAGE
Over the past two decades, we have continually expanded our drainage portfolio to include a diverse range of solutions that work together to help you achieve optimal drainage care. We offer multiple drainage catheters designed to lessen trauma and promote a more accurate placement.
ELECTROPHYSIOLOGY & CRM
Successful diagnosis and treatment of electrical cardiac activity is crucial—this is why we offer a range of physician education courses and specialized tools to assist in making accurate diagnoses and create effective treatment plans. Features include extra-stiff transseptal needles, ergonomic handles for exceptional control, and advanced introducer systems.
EMBOLOTHERAPY
Our proprietary embolic products are the most studied on the market and allow for efficient and safe delivery and predictable outcomes. To complement our offerings, we provide excellent ongoing customer service to ensure you have the tools you need for your procedures.
PROSTATIC ARTERY EMBOLIZATION
To help support your prostatic artery embolization (PAE) practice, we offer virtual and hands-on training, trusted products, clinical resources, patient materials, and more.
UTERINE FIBROID EMBOLIZATION
Our uterine fibroid embolization (UFE) solutions offer trusted products that deliver predictable clinical results as well as long-term symptom control.
We also offer extensive patient resources at our Ask4PAE and Ask4UFE sites.
GASTROENTEROLOGY STRICTURE MANAGEMENT
Merit Endoscopy’s fully covered, laser-cut esophageal stent technology provides for accurate placement and minimized migration. In addition to our state-of-the-art stent technology, we deliver best-in-class dilation products, including our BIG60® Inflation Device and our Elation dilation balloons as well as enhanced physician training.
PULMONARY STRICTURE MANAGEMENT
For patients with tracheobronchial strictures, stent technology can provide rapid palliation and improve quality of life. We offer fully covered, laser-cut tracheobronchial stents and advanced over-the-wire and direct visualization delivery systems. Download case studies and participate in virtual and hands-on training—all designed to help you advance patient care.
KITS & PACKS
Designed to bring convenience and efficiency to your office, our kits and packs solutions can help simplify prep and procedure, support quality patient care, and reduce inventory levels. Our team analyzed hundreds of kits and created a set of standard configurations that meet the needs of the majority of cath labs, interventional radiology, and vascular surgery departments. We also offer customizable kits to fit your unique procedural needs.
SPINE
Through a diverse portfolio of sophisticated steerable technologies, we deliver complete procedural solutions designed to treat pathologies of the vertebrae, reduce pain, and improve patient quality of life. Our comprehensive education programs and unique products allow physicians to address patient-specific needs and physician preference in the treatment of vertebral pathologies.
VENOUS
Our minimally invasive venous solutions are designed to treat symptoms, minimize post-operative pain, and provide faster recovery. Explore products, accessories, and kits, packs, and trays—each complementing the next to provide you with better patient outcomes.
Merit’s dedication to comprehensive customer care starts with providing the tools you need to treat your patients. Ready to get started? Available via email, phone, and live chat, our Customer Support team is here to help find a solution for you. Browse our virtual in-service and product support videos, all designed to help you obtain additional product knowledge and insights. We look forward to working with you.
Merit Brings Awareness to Men’s Health During the Month of June
It’s June and officially Men’s Health Month, a time dedicated to the raising awareness of health issues that affect men and boys, encouraging early detection and treatment of these conditions.
At Merit Medical, it’s our goal to not only provide the tools physicians need to treat and improve patient outcomes but also share knowledge and increase awareness surrounding risk factors for disease.
We understand that illness affects both men and women, but to offer the best patient care, it’s also important to shed light on diseases that are more prevalent in one sex versus the other.
Here are just some of the illnesses that are seen more frequently among men—and how we help care for each.
ESOPHAGEAL CANCER
Esophageal cancer is cancer found in the esophagus—the hollow, muscular tube in your body that carries food and liquid from the throat to the stomach. Men are around three times more likely than women to have esophageal cancer.
- Avoid alcohol.
- Eat more fruits and vegetables.
- Maintain a healthy weight.
- Exercise regularly.
Learn more about esophageal cancer.
MERIT PRODUCTS
LUNG CANCER
Lung cancer is a type of cancer that begins in the lungs. It is the leading cause of cancer deaths worldwide. The overall chance of a man developing lung cancer in his lifetime is approximately 1 in 15, whereas for a woman, the risk is about 1 in 17.
- Quit smoking (or don’t start).
- Stay away from secondhand smoke.
- Test your home for radon.
- Avoid cancer-causing chemicals.
- Live a healthy lifestyle.
MERIT PRODUCTS
KIDNEY FAILURE
Although more women than men are diagnosed with chronic kidney disease, or CKD, men are more likely to reach kidney failure sooner.
Although kidney failure can happen to anyone, men may be more at risk compared to women due to differences in hormones and living unhealthier lifestyles.
- Get a kidney check-up at least every year.
- Control your blood pressure and blood sugar.
- Stop smoking (or don’t start).
- Exercise and eat a healthy diet.
- Maintain a healthy weight.
- If you have an enlarged prostate, talk with your doctor to make sure it’s not blocking your urinary tract.
- Give your doctor a list of any supplements, medicines, and/or hormone treatments you’re taking to ensure they aren’t damaging your kidneys.
Learn more about kidney failure and visit our Dialysis Access Solution page.
MERIT PRODUCTS
AORTIC ANEURYSM
The aorta runs from the heart through the center of the chest and abdomen. It’s the main blood vessel that brings blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm (AAA) is a life-threatening condition that occurs when the vessel enlarges, putting it at risk of bursting. Men are 4-15 times more likely to develop an AAA than women
- Stop smoking (or don’t start).
- Reduce stress.
- Exercise and eat a heart-healthy diet.
- If you have diabetes or high blood pressure, take the medicines your doctor has prescribed.
Learn more about AAA. To learn more about our packs, wires, and other cardiac products, please visit our Merit Vascular page.
MERIT PRODUCTS
HEART ATTACK
A heart attack, also known as a myocardial infarction, occurs when heart muscle doesn’t receive enough blood. As time passes without receiving treatment, the more damage is done to the heart. The main cause of a heart attack is coronary artery disease (CAD). Researchers have found that throughout life, men are about twice as likely as women to have a heart attack.
- Eat a healthy diet.
- Maintain a healthy weight.
- Exercise regularly.
- Stop smoking (or don’t start).
- Monitor your cholesterol and blood pressure.
- Manage your diabetes.
- Take your prescribed medicines.
Learn more about heart attacks. Explore our Cardiac Portfolio, including our radial sheaths, catheters, wires, and compression devices.
MERIT PRODUCTS
LIVER CANCER
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is most often seen in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C. Worldwide, HCC is the fourth leading cause of cancer death and is 3 times more common among males than females.
- Avoid heavy alcohol use.
- Reduce exposure to aflatoxin B1.
- Stop smoking (or don’t start).
- Get the hepatitis B vaccine.
- If you have hepatitis, work with your care provider to receive treatment.
Learn more about liver cancer. Visit our Hepatic Oncology portfolio.
MERIT PRODUCTS
BENIGN PROSTATIC HYPERPLASIA (BPH)
Benign prostatic hyperplasia, or BPH, is the enlargement of the prostate gland and affects only men. It becomes more common as men get older. Up to 90% of men over the age of 80 have BPH. Although BPH is noncancerous, it can cause bothersome lower urinary tract symptoms.
- Maintain a heart-healthy diet.
- Avoid heavy alcohol use.
- Exercise regularly.
Explore the products we offer to support prostatic artery embolization (PAE), a minimally invasive option to treat BPH.
MERIT PRODUCTS
At Merit Medical, our goal is to improve the lives of people, families, and communities worldwide. An important part of this is caring for men’s health by providing the products and therapies needed for patients to live at their best.
Have questions? Reach out to our Customer Support team.
Before using, refer to Instructions for Use for indications, contraindications, warnings, precautions, and directions for use.
Merit Recognizes National Kidney Month & World Kidney Day
National Kidney Month and World Kidney Day are here, and both are very important times we recognize at Merit Medical. All over the globe, you will find the Merit family raising awareness about kidney disease as well as continuing to ensure our dialysis products and education services are available to clinicians and their patients.
Kidney disease is a global issue. Approximately 2 million people worldwide suffer from kidney failure, and the number of patients diagnosed with the disease continues to increase at a rate of 5—7% per year.1 As many people worldwide currently receive treatment with dialysis or a kidney transplant to stay alive, yet this number may only represent 10% of people who actually need treatment to live.2
Through our dedication and the supportive programs, high-quality products, and services we provide, our team acts as an ambassador for better dialysis care. Here’s how.
OUR DEDICATION
Our Dialysis team is made up of expert clinical support specialists, sales representatives, portfolio managers, and more—all dedicated to ensuring our products and services are made available to the clinicians and patients who need them.
OUR PRODUCTS
Our diverse portfolio of dialysis access products provides what clinicians need from stick to stitch.
This includes reliable hemodialysis options, such as the HeRO® Graft—the only fully subcutaneous AV access solution clinically proven to maintain long-term access for hemodialysis patients with central venous stenosis.
For peritoneal dialysis (PD) care, we offer state-of-the-art Flex-Neck® Peritoneal Dialysis Catheters. With a larger internal diameter over competitive catheters, Flex-Neck catheters allow for higher flow rates than other catheters on the U.S. market.3 Catheter Implantation Kits are also available, designed to streamline the implantation procedure and promote efficiency.
Clinicians can also choose from an assortment of other hemodialysis products, such as the Centros® Hemodialysis Catheters or ProGuide™ Chronic Dialysis Catheters as well as innovative renal accessories, such as the Slip-Not® Suture Retention Device.
Browse through our entire collection of Dialysis Access Solutions.
OUR SERVICES
Clinician Training
At Merit, our goal is to not only provide high-quality dialysis products but also offer the training and support needed for clinicians to give patients optimal dialysis care. In turn, we also offer helpful resources patients can use to familiarize themselves with all dialysis treatment options.
To adapt our training options during the pandemic, we offer a Virtual Percutaneous PD Webinar for physicians and a Virtual Dialysis Access CE Program for nurses, dialysis technicians, and other healthcare professionals.
Visit us here to register for these virtual training opportunities as well as learn about our Think Dialysis Access™ physician education program.
Clinical Case Support
To better aid clinicians in dialysis access cases, we also have a dedicated team of dialysis access clinical specialists who understand the intricacies of hemodialysis and PD and are ready to support. From explaining correct Merit product use to on-site troubleshooting, Merit clinical specialists are available to assist.
Patient Education: Ask4PD
A significant part of improving dialysis care is ensuring patients understand their treatment options. Ask4PD.com is a patient education site powered by Merit that’s dedicated to helping patients understand dialysis care, especially PD. Individuals have access to helpful resources, including patient and healthcare professional testimonials.
MORE RESOURCES
Learn more about kidney health, kidney disease, and treatment with these helpful resources:
- National Institute of Diabetes and Digestive and Kidney Diseases (NIH)
- American Association of Kidney Patients
- American Kidney Fund
- DaVita
- American Renal Associates
- Dialysis Patient Citizens
- Fresenius Kidney Care
- Home Dialysis Central
This National Kidney Month, World Kidney Day, and every day, our team at Merit is dedicated to being your partner in providing better dialysis care.
Explore our complete Dialysis Access portfolio and connect with our Customer Support Center to see how you can incorporate these solutions into your dialysis practice today.
References
- University of California San Francisco. 2018. “The Kidney Project.” https://pharm.ucsf.edu/kidney/need/statistics
- National Kidney Foundation. n.d. “Global Facts: About Kidney Disease.” https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease#:~:text=Over%202%20million%20people%20worldwide,actually%20need%20treatment%20to%20live.
- Katzman HE et al. 2009. “Initial Experience and Outcome of a New Hemodialysis Access Device for Catheter-Dependent Patients. J Vasc Surg Sep;50(3):600-607
WRAPSODY™ Inhibits Cell Migration, Tissue Accumulation Across Graft Layers, Helping to Maintain Vessel Patency
Hemodialysis access failures take a great toll on a patient’s quality of life. Frequent hospital admissions, invasive diagnostic tests, and open and endovascular reinterventions are associated with increased morbidity.1 Maintaining vessel patency in hemodialysis patients is critical; however, surgical access durability is temporary at best, with half-life for arteriovenous grafts lasting approximately one year and arteriovenous fistulas providing only slightly better outcomes.1 A common failure of hemodialysis access is stenosis or occlusion of the dialysis outflow circuit. Obstructions caused by cellular migration and tissue accumulation across graft ePTFE layers can be a contributing factor.
Addressing this clinical challenge, Merit Medical® introduced the Merit WRAPSODY™, a novel endoprosthesis designed with a revolutionary cell-impermeable middle graft layer. With this unique feature, the Merit WRAPSODY Endoprosthesis inhibits transmural cellular migration without the use of drug bonding, helping to prevent obstructions from forming within the endoprosthesis.
To evaluate device performance, Dolmatch et al. published a study 2 in the Journal of Vascular and Interventional Radiology comparing the patency, cellular response, and thrombogenicity of the Merit WRAPSODY with that of a leading ePTFE covered stent. Both Merit WRAPSODY and leading ePTFE covered stent grafts were implanted in the external iliac arteries of 14 adult sheep for 30 (n = 4), 90 (n = 4), and 180 (n = 6) days. Angiographic patency and percent diameter stenosis (%DS) were assessed at termination. Excised stent grafts were fixed and stained for histopathologic analysis, including neointimal coverage (NC) assessment.
Results showed that the Merit WRAPSODY had lesser mean %DS in comparison to the leading ePTFE covered stent: 4.6% vs. 8.2% (P = .563), 2.0% vs. 10.9% (P = .363), and 2.1% vs. 10.3% (P = .009) at 30, 90, and 180 days, respectively. In addition, median NC scores at 30, 90, and 180 days were significantly lower in middle Merit WRAPSODY sections (P <.05). Proximal and distal Merit WRAPSODY and leading ePTFE covered stent sections exhibited similar median NC scores at all time periods (P >.05).
The authors of the study concluded that the Merit WRAPSODY’s cell-impermeable middle graft layer prevented cellular migration and tissue accumulation across device layers and around nitinol stent struts better than the leading ePTFE covered stent.
In addition to animal models, human trials to investigate the Merit WRAPSODY’s safety and effectiveness are currently underway. The WRAPSODY FIRST, an ongoing clinical trial, will have 6-month and 12-month patency data available at the beginning of next year. Moreover, the WRAPSODY AV Access Efficacy (WAVE) IDE study is expected to start enrolling patients in January 2021. Merit received the CE mark for the Merit WRAPSODY™ from the British Standards Institution (BSI) earlier this year.
Every day Merit works to create solutions to clinical challenges that once seemed impossible. Engineered with dialysis patients in mind, the Merit WRAPSODY Endoprosthesis provides a viable treatment option that preserves functional hemodialysis access.
Discover the Merit WRAPSODY and its many innovative design features by visiting the product page, and contact Customer Service for more information about how you can incorporate the Merit WRAPSODY into your practice.
Related
InQwire® Amplatz Guide Wire
basixTOUCH40™ Inflation Device
Advocate™ PTA Catheters
References
- Rodriguez, Eduardo, et al. 2017. “Hemodialysis Outflow Vein Stenosis.” In Hemodialysis Access Fundamentals and Advanced Management, edited by Sherene Shalhub, Anahita Dua, and Susanna Shin, 257–263. Switzerland: Springer International Publishing.
- Dolmatch, Bart L., John W. Hall, Wayne L. Mower, and Serge D. Rousselle. 2020. “Evaluation of a Novel Spun Polytetrafluoroethylene Stent Graft in an Ovine External Iliac Artery Model.” Journal of Vascular and Interventional Radiology 31: 494–502.
Now Available in the US, Surfacer® System Provides Treatment Option for Venous Obstructions
Merit Medical® is committed to offering products that provide patients with better dialysis access options. The newest of these innovations is the Surfacer® Inside-Out® Access Catheter System, a unique device designed to obtain right-sided central venous access in patients with venous obstructions. The Surfacer System received FDA De Novo classification in the US earlier this year and has been CE marked in Europe since 2016.
The current clinical approach when treating dialysis patients with chronically occluded central veins is to use another vein if a subsequent central venous catheter is needed. Failed venous access attempts may prevent permanent arteriovenous access, increasing patient morbidity and the overall cost of care.1
Designed to gain central venous access, the Surfacer System works by inserting the device through the right femoral vein and navigating it up through the patient’s venous system with an exit point in the right internal jugular vein, the optimal location for placing a central venous catheter. Watch how the Surfacer System works.
This proprietary “Inside-Out” approach supports the achievement of permanent arteriovenous access, which reduces hemodialysis provider cost and patient downtime by decreasing catheter-related morbidity and complications.1
Additional clinical benefits of using the Surfacer System were seen in its first-in-human study.2 Results showed that 100% of patients experienced successful central venous access placement, and 100% of patients maintained central venous access patency through long-term follow up. No device-related adverse events were reported at short- or long-term follow up. To learn more about the Surfacer System’s first-in-human study, view the article published in Endovascular Today.
In May of this year, the Surfacer System’s first US-based commercial cases were completed at Santa Clara Valley Medical Center in San Jose, California, one of several clinical sites for the US investigational device exemption (IDE) study, which led to FDA De Novo status. Ehab Sorial, MD, and Ajit Nair, MD, performed the procedures in two hemodialysis patients with central venous obstructions, one of which had limited access options.
“The Surfacer System provides us with a safe and effective option for obtaining right-sided central venous access in patients with venous obstructions, enabling us to preserve secondary central veins and avoid alternative access procedures, which are not as effective and have a higher risk of complications,” explained Drs. Sorial and Nair in a press release. Read the full press release here.
Merit currently distributes the Surfacer System in North America and Europe. With the device’s recent launch in the US, Merit is proud to play an integral role in providing physicians with life-saving technologies for their patients around the world.
Discover the Surfacer Inside-Out Access Catheter System and explore Merit’s entire portfolio of renal therapies and accessories.
All trademarks are property of their respective owners.
REFERENCES
- Data on file at Bluegrass Vascular Technologies, Inc.
- Ebner, A., S. Gallo, C. Cetraro, J. Gurley, and L. Minarsch. 2013. “Inside-Out Upper Body Venous Access: The First-in-Human Experiences with a novel Approach Using the Surfacer Inside-Out Access Catheter System.” Endovascular Today. June 2013. https://evtoday.com/articles/2013-june/inside-out-upper-body-venous-access.
For Katie, Dialysis Care Meant More Time with Her Mom
Katie’s story began the day Kay started hemodialysis in 2008. “She struggled to get a vascular access,” Katie recalled. “She had a failed graft and a failed fistula, and we had no other options.”
During this time a surgeon recommended the Merit HeRO® Graft, a hemodialysis access graft designed for patients like Kay who are failing conventional fistulas or grafts. “She either needed the HeRO, or she wouldn’t be with us,” Katie said. “After struggling in and out of the hospital, surgery after surgery, accesses failing, and her not feeling well, we pursued the HeRO, and it was successful. She got to enjoy life for nine years.”
Those nine years, Katie explained, were significant and happy ones for Kay and her family. Kay was able to attend both Katie’s and her husband’s graduations as well as see her become a dialysis nurse. She was there to see her granddaughter born and watch as her grandson graduated high school, become a marine, get married, and have a child of his own—making Kay a great grandmother.
“There are too many words to describe her,” Katie said. “She made me who I am today. We are so sad to be without her, yet so thankful for those nine years.”
Merit’s commitment to improving lives is what drives the innovation of products that help people like Kay live longer, providing hope to them and their families.
Home Dialysis Continues to Be a Nationwide Interest
Home dialysis remains in the U.S. spotlight, as seen in the December 2019 Nephrology News & Issues cover story “Home Dialysis Options Can Assist in Clinical Decision-Making.” Written by Stephen E. Hohmann, MD, FACS, one of Merit’s Think Dialysis Access™ proctors, the article discusses the advantages of home dialysis options, such as peritoneal dialysis (PD). Home dialysis became a topic of interest earlier in 2019 when the White House announced working on a new payment approach for treating kidney disease that favors home-based dialysis options.1
In the article, Dr. Hohmann suggests that advances in PD catheters and implantation systems have made the procedure and treatment more efficient. “Advances in PD catheters have facilitated more streamlined implantation while also potentially giving patients better dialysis fluidic dynamics,” he writes. “Catheters with a larger internal diameter (3.5 mm) compared to other on-market devices can be used, which allows for use of higher flow rates.”2
The catheters Dr. Hohmann refers to are Merit’s Flex-Neck® PD Catheters, the only PD catheters on the market with an inner diameter of 3.5 mm (except for infant-sized catheters). With a 3.5 mm inner diameter, the Flex-Neck is 35% larger than competitive catheters (at 2.6 mm ID), resulting in up to 30% higher flow rates.3 Higher flow rates can translate into reduced treatment times, allowing patients more freedom to do the things they love.
Dr. Hohmann mentions other home dialysis patient advantages that include “more profound improvements in blood pressure control, better kidney disease-related quality of life and shorter recovery time from dialysis treatments . . . compared to similar patients on in-center dialysis.”2 Such benefits are also associated with PD compared to in-center hemodialysis.2 The broader implementation of home dialysis PD care in particular has economic advantages. Dr. Hohmann explains that “a 5% increase in utilization of PD instead of in-center hemodialysis could save as much as $295 million annually.”2
With the increased emphasis on home dialysis, physicians and surgeons across the country are seeking training to support their transition to PD implantation. Merit has been proud to support this initiative with training as part of our Think Dialysis Access™ program, and we will continue rolling out opportunities throughout the upcoming year.
Explore Merit’s support for PD and home dialysis at Merit.com/PD.
Read the full December 2019 Nephrology News & Issues article here.
REFERENCES
- Copley, C., & Humer, C. (2019, March 3). U.S. seeks to cut dialysis costs with more home care versus clinics. Retrieved fromhttps://www.reuters.com/article/us-usa-healthcare-dialysis/us-seeks-to-cut-dialysis-costs-with-more-home-care-versus-clinics-idUSKCN1QL0G6
- Hohmann, S.E. (2019 Dec.). Home dialysis options can assist in clinical decision-making. Nephrol News Issues. Retrieved from https://www.healio.com/nephrology/kidney-care-community/news/print/nephrology-news-and-issues/%7Bdfac0f88-1d95-48bc-bc56-87070b4e611e%7D/home-dialysis-options-can-assist-in-clinical-decision-making
- Data on file.
HeRO™ Graft Bypasses Central Venous Stenosis, Improves Hemodialysis
Central venous stenosis is a common and serious vascular complication among long-term hemodialysis patients that can lead to the loss of vascular access and a diminished life expectancy. To bypass venous stenosis and improve long-term hemodialysis adequacy, various permanent subcutaneous arteriovenous graft devices have been manufactured as a solution for hemodialysis patients who have exhausted all other access options.
One such product called the HeRO™ Graft was approved by the FDA in 2008. In comparison to catheters, it’s the only clinically proven permanent subcutaneous arteriovenous graft to reduce the risk of vascular access-related infections by 69%, improve adequacy of hemodialysis by up to 32% (1.7 Kt/V), and cut interventions needed to maintain access function by more than half.1 Studies have also linked the HeRO Graft to high cumulative patency rates that reach 87% at two years.2
Cost savings advantages have also been linked with using the HeRO Graft. A US healthcare model for provision of hemodialysis access predicted that in comparison to catheters, using the HeRO Graft could result in an average of 23% annual savings.3 Dialysis centers could save over $3000 per patient each year.4 And hospitals can save thousands in hefty admission costs that accrue because of device-related infections—rates that would commonly range between $23K to $56K per stay.5,6
What makes the HeRO Graft so unique?
Unlike other graft products, the HeRO Graft doesn’t depend on venous anastomosis to bypass venous stenosis. Instead, a radiopaque silicone Venous Outflow component reinforced with kink and crush-resistant nitinol braid is placed in the right atrium and securely attaches to an adjacent ePTFE hemodialysis graft by way of a proprietary titanium connector. This mechanism allows for blood to return from the arteries back to the heart.
To learn more about the HeRO Graft and how you can apply it to your practice, sign up for the upcoming Think HeRO training course held on March 30-31 at the Houston Methodist Institute for Technology, Innovation & Education (MITIESM) in Houston, Texas, by talking to your Merit representative or visiting Merit.com/Education
- Katzman, H., McLafferty, R., Ross, J., Glickman, M., Peden, E., & Lawson, J. (2009). Initial experience and outcome of a new hemodialysis access device for catheter-dependent patients. J Vasc Surg, 50(3): 600-607.e1.
- Gage, S., Katzman, H., Ross, J., Hohmann, S., Sharpe, C., Butterly, D., & Lawson, J. (2012). Multi-center experience of 164 consecutive Hemodialysis Reliable Outflow [HeRO] Graft implants for hemodialysis treatment. Eur J Vasc Endovasc Surg, 44(1): 93-99.
- Dageforde, L., Bream, P., & Moore, D. (2012). Hemodialysis Reliable Outflow (HeRO) device in end-stage dialysis access: a decision analysis model. J Surg Res, 177(1): 165-171.
- Yost, L., Dinwiddie, L. (2010, Nov.). Impact of the use of the HeRO vascular access graft vs. tunneled dialysis catheters on dialysis provider economics in an era of bundling. Poster session presented at ASN, American Society of Nephrology, Denver, CO.
- Ramanathan, V., Chiu, E., Thomas, J., Khan, A., Dolson, G., & Darouiche, R. (2007). Healthcare costs associated with hemodialysis catheter–related infections: a single‐center experience. Infect Control Hosp Epidemiol, 28(5): 606-609.
- O’Grady, N., Dellinger, E., Gerberding, J., Heartd, S. Maki, D., Masur, H., McCormick, R., Mermel, L., Pearson, M., Raad, I., Randolph, A., & Weinstein, R. (2002). Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention, U.S. Pediatrics, 110(5): e51.
Merit Addresses Growth in Home Dialysis Care with Patient and Physician Tools
There has been a recent shift in kidney care with both industry leaders and the White House showing support of home dialysis. This forward momentum is due to several advantages home dialysis offers patients, such as lower mortality rates,1 flexible treatment schedules,2 and reduced cost.3 Merit Medical is pleased to support this transition by providing dialysis patient education, clinician training, and a number of therapeutic products.
Heading the movement are international industry leaders DaVita® Kidney Care and Fresenius Kidney Care with an initiative called 20% by 2020, a program that aims to have 20% of dialysis patients on home dialysis therapy by the year 2020. Both DaVita and Fresenius provide two types of home dialysis options: peritoneal dialysis (PD) and hemodialysis.
“The initiative is important from several standpoints,” says John H. Crabtree, MD, general surgeon, chair of PD University for Surgeons-North America, and visiting clinical faculty at Harbor-UCLA Medical Center in Torrance, CA. “Number one, patients do better on home dialysis.”
Patients on PD therapy in particular, a group that comprises the majority of the home dialysis-treatment population, “have improved survival over the early years on treatment,” Dr. Crabtree told Merit Medical.4 Moreover, for individuals who receive a kidney transplant, “the results tend to be better when they were on peritoneal dialysis prior to the surgery as opposed to hemodialysis.”5
Home dialysis also offers greater autonomy. Because patients are properly trained and therapy can be done overnight, home dialysis allows for a regular work schedule.3 Moreover, the average cost of care for home dialysis is less.3 PD in particular, Dr. Crabtree went on to explain, is approximately $15,000 less per patient per year compared to hemodialysis.6
The White House recently announced a new government-sponsored payment approach for treating kidney disease that favors lower cost home dialysis. The U.S. Centers for Medicare and Medicaid Services is considering a trial program design that would improve care in the early stages of kidney disease, increase access to kidney transplants, and favor home dialysis over clinic-based treatment.3 It is particularly looking at the benefits of PD.3
Despite these advantages and the fact that many physicians believe 25%–35% of patients would do better on home dialysis therapy, the number of people receiving home dialysis in the US still remains low, with only 7% receiving PD and less than 1% choosing home hemodialysis.7 The 20% by 2020 initiative plans to change this through several avenues.
“The way that we can drive this is by improving patient education…Many patients aren’t provided information about home dialysis,” Dr. Crabtree explains. In addition to patient education, Dr. Crabtree says many physician education programs lack the training needed to take care of PD patients. “[I]t’s important to provide courses [and] educational opportunities that allow them to have hands-on training.”
Merit Medical is ready to address these needs through its Ask4PD™ patient education site and ThinkDialysisAccess™ hands-on physician training experiences. Merit also offers high-quality dialysis products, such as the Flex-Neck® Peritoneal Dialysis Catheter, a premium catheter that allows for up to 30% higher flow rates than other catheters currently on the US market.8
The support for home dialysis is expanding. By providing the tools and education needed to advance the 20% by 2020 initiative, Merit shows its ongoing evolution as a healthcare company as well as its vision to continually find ways to improve patient care.
Watch Dr. Crabtree’s interview to learn more about the benefits of home dialysis and how Merit supports it.
Dr. Crabtree is a paid consultant of Merit Medical.
REFERENCES
- DaVita® Kidney Care. (n.d.). Top 5 benefits of home dialysis treatment. Retrieved from https://www.davita.com/treatment-services/home-dialysis/home-benefits/top-5-benefits-of-home-dialysis-treatment.
- Fresenius Kidney Care. (2019). Learn more about home dialysis treatment options. Retrieved from https://www.freseniuskidneycare.com/ckd-treatment/benefits-of-home-dialysis.
- Copley, C., & Humer, C. (2019, March 3). U.S. seeks to cut dialysis costs with more home care versus clinics. Retrieved from https://www.reuters.com/article/us-usa-healthcare-dialysis/us-seeks-to-cut-dialysis-costs-with-more-home-care-versus-clinics-idUSKCN1QL0G6.
- Teixeira, J.P., Combs, S. A., & Teitelbaum, I. (2015). Peritoneal dialysis: Update on patient survival. Clin Nephrol, Jan;83(1):1-10.
- Joachim, E., Gardezi, A. I., Chan, M. R., et al. (2017). Association of pre-transplant dialysis modality and post-transplant outcomes: A meta-analysis. Perit Dial Int, May-Jun;37(3):259-265.
- United States Renal Data System. (2018). 2018 annual data report (Chapter 9: Healthcare expenditures for persons with ESRD). Retrieved from https://www.usrds.org/2018/view/v2_09.aspx
- DaVita Kidney Care. (n.d.). Majority of nephrology professionals prefer home dialysis. Retrieved from https://www.davita.com/treatment-services/home-dialysis/recommended-approach.
- Data on file.
Charing Cross 2019
Explore Innovative new products and Hands-on Learning with Merit Medical
Venous Therapy:
• ClariVein® Infusion Catheter
• Hands-on Opportunity: Experience operation of the ClariVein while learning about its many patient and operator advantages
Dialysis Access:
• Surfacer® Inside Out® Access Catheter System
• Hands-on Opportunity: Try out the unique Surfacer System and learn how it can reliably provide central venous access in patients with occluded veins
• HeRO Graft and Super HeRO
• Learn which additional grafts can now be used with the HeRO Adapter.
• Hands-on Opportunity: See the differences and feel the improved pushability of the new Venous Outflow Component.
• See how the Merit Prelude Short Sheath, with its’ excellent tip transition and large bore stopcock, is ideally suited for fistula and graft management.
Vascular Access and Navigation:
• Try out the Merit Amplatz InQwire and feel how its’ smooth tapered transition from the shaft to the flexible tip allows atraumatic negotiation of the most difficult anatomy
• See the full range of Merit’s Mini Access Kits designed to reduce tissue trauma and bleeding
Balloons and Inflation Devices:
• Try out the new Merit basixTAU Inflation Device that reduces the rotational force needed during inflations and minimizes the chance for hand fatigue.
• Introducing the new family of Advocate PTA Catheters, including 014”, 018”, and 035”
• Take the opportunity at the Merit booth to get hands-on experience inflating the Q50+ Stent Graft Balloon with the widest range of inflation diameters for AAA.
Merit Medical Supports National Kidney Month
In honor of National Kidney Month and World Kidney Day on March 14th, Merit Medical shows its ongoing commitment to renal health through its diverse portfolio of high-quality therapeutic products, various clinician training opportunities, and dialysis patient education.
The latest U.S. Renal Data System Annual Data Report confirmed that more than 660,000 Americans are being treated for end-stage renal disease; of these, 468,000 are dialysis patients.[1] Around the world, the number of individuals diagnosed with end-stage renal disease continues to increase by 5%–7% per year.2
To help physicians care for this growing patient population, Merit provides a broad array of innovative products that provide reliable access for both hemodialysis and peritoneal dialysis (PD) treatments.
The HeRO® Graft is a hemodialysis access graft for patients who are failing fistulas, or grafts, or are approaching catheter dependency due to the blockage of veins, causing an outflow insufficiency. It’s the only fully subcutaneous AV access solution clinically proven to maintain long-term access for hemodialysis patients with central venous stenosis. The HeRO’s proprietary design has translated into fewer infections and superior dialysis adequacy compared to tunneled dialysis catheters.3
Physicians can also choose from an assortment of other hemodialysis products, such as the Centros® Hemodialysis Catheters or the ProGuide™ Chronic Dialysis Catheters and ancillary products like micro-introducers, wires, and sheaths.
Merit PD care includes the state-of-the-art Flex-Neck® Peritoneal Dialysis Catheters. With a larger internal diameter over competitive catheters, Flex-Neck catheters allow for higher flow rates than other catheters on the U.S. market.4 Catheter Implantation Kits are also available, designed to streamline the implantation procedure and promote efficiency.
Dialysis support continues with ThinkDialysisAccess™ hands-on physician training courses intended for surgeons and interventionalists. These immersive experiences use cadavers, case reviews, and problem-solving techniques in preparation for implantation of the HeRO Graft and/or the Merit PD catheter system. Learn more about upcoming course dates.
To better aid physicians in dialysis access cases, Merit has a dedicated team of dialysis access clinical specialists who understand the intricacies of hemodialysis and PD and are ready to support. From explaining correct Merit product use to on-site troubleshooting, Merit clinical specialists are available to assist.
Educational events across the nation are also offered for physicians who are interested in providing optimal care for dialysis patients. By hosting dinner lectures with clinical educators and experts in the dialysis field, Merit gives physicians a space to ask questions, discuss challenges, learn about Merit therapeutic devices and education courses, and share ways to improve dialysis care. The website lists upcoming ThinkDialysisAccess™ courses throughout the year. The course on April 8 is designed specifically for Fellows (Peritoneal Dialysis and HeRO Graft implantation techniques) and on April 10-12 the focused will be on Peritoneal Dialysis Access techniques.
A significant part of improving dialysis care is ensuring patients understand their treatment options. Ask4PD.com is a patient education site powered by Merit Medical that’s dedicated to helping patients understand dialysis care, especially PD. Individuals have access to helpful resources, including patient and healthcare professional testimonials.
Join Merit in recognizing National Kidney Month and World Kidney Day, and learn more about the many therapeutic devices, accessory products, and services provided to improve dialysis treatment.
REFERENCES
- National Kidney Foundation. (2016 Jan). End stage renal disease in the United States. Retrieved from https://www.kidney.org/news/newsroom/factsheets/End-Stage-Renal-Disease-in-the-US
- University of California San Francisco. (2014). The kidney project, statistics. Retrieved from https://pharm.ucsf.edu/kidney/need/statistics
- Katzman, H. E., McLafferty, R. B., Ross, J. R., et al. (2009). Initial experience and outcome of a new hemodialysis access device for catheter-dependent patients. J Vasc Surg, Sep;50(3):600-607.
- Internal data.