Personalized NIR-II probes for comprehensive monitoring and evaluation of dialysis vascular access.

Vascular access is regarded as the "lifeline" for maintaining hemodialysis in patients with end-stage renal disease (ESRD). An optimal vascular access ensures adequate blood flow, thereby facilitating effective dialysis and enhancing patient quality of life. Here, we develop near-infrared-II (NIR-II) imaging with individualized NIR-II probes to optimize preoperative and postoperative evaluations of hemodialysis vascular access. The β-LG@IR-780 with renal excretion can clearly visualize the macroscopic vascular network preoperatively, thereby optimizing surgical planning. Postoperatively, multi-channel crosstalk-free imaging enables real-time assessment of arteriovenous fistula maturation, patency, and thrombus formation within grafts, while simultaneously delineating the anatomical structures and hemodynamic characteristics of graft vessels, autologous vessels, and surrounding nerves/lymphatic systems. In chronic kidney disease (CKD) models, the rapid hepatobiliary-excreted probe IR-808Ac is essential-it circumvents metabolic interference from renal impairment on renally cleared probes, enabling repeated safe and effective in vivo imaging. Our strategies enable real-time monitoring and complication diagnosis, not only improving surgical accuracy and reducing intraoperative bleeding but also enhancing the success rate of arteriovenous fistulas and patient quality of life. This technique holds broad clinical application prospects and substantial promotion value.