5 Best HeRO Graft Alternatives & Competitors (2026)

The HeRO Graft is a fully subcutaneous hybrid vascular access device used for hemodialysis patients with central venous occlusion who cannot receive conventional upper-arm fistulas or grafts. It combines an ePTFE graft with a nitinol-reinforced venous outflow component that bypasses stenosed central veins to the right atrium. Unlike VenoStent's investigational bioabsorbable wrap intended to support maturing fistulas, HeRO is immediately available, surgically implanted, and reimbursed today. It serves a narrower rescue-access population rather than prophylactic support of new fistulas. Long-term data show acceptable patency but higher infection rates than native vessels. Relevance to VenoStent searchers is high when central venous disease precludes standard options.

Propaten is a heparin-bonded ePTFE vascular graft intended to reduce thrombosis in peripheral and dialysis applications. It offers improved patency over standard PTFE in some studies. Compared with VenoStent's resorbable external wrap designed to enhance native fistula biology, Propaten is a permanent synthetic conduit used when autologous options are exhausted. It is widely available and reimbursed. The product serves a different clinical niche but appears in alternative searches focused on lowering access failure rates today.

The Surfacer system enables recanalization of occluded central veins via an inside-out approach, restoring upper-body access options for dialysis patients. It addresses anatomy that would otherwise require lower-body catheters. While VenoStent focuses on supporting new fistulas externally, Surfacer rescues existing access pathways. It is cleared and used in specialized centers. Relevance is moderate for comprehensive alternative research covering both prevention and salvage strategies.

Flixene is a trilaminate ePTFE graft engineered for early cannulation in dialysis access. It reduces time to first use compared with standard grafts. Unlike the bioabsorbable concept behind SelfWrap, Flixene remains permanently implanted. It is commercially distributed and positioned for patients needing rapid access creation. Relevance exists for those exploring all synthetic graft alternatives while VenoStent completes trials.