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Vascular Gel-E is an experimental bioactive hydrogel designed to enhance the maturation and long-term patency of arteriovenous fistulas (AVF) in patients with end-stage renal disease. Developed by Vascular Genesis, the product is composed of a polyethylene glycol (PEG) hydrogel matrix that incorporates the recombinant extracellular domain of the Ephrin-B2 ligand. During the surgical creation of an AVF, the gel is applied topically to the adventitial (external) surface of the vein. The Ephrin-B2 ligand then interacts with EphB4 receptors on the venous wall, stimulating a biological process known as "arterialization." This process involves the coordinated remodeling of the vessel, including smooth muscle cell proliferation and increased wall thickness, which allows the vein to adapt to the high-pressure arterial blood flow required for hemodialysis. By promoting successful maturation, Vascular Gel-E aims to reduce the high incidence of primary AVF failure and the need for subsequent corrective interventions.
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