TY - JOUR
TI - Local Hemodynamics and Intimal Hyperplasia at the Venous Side of a
Porcine Arteriovenous Shunt
AU - Manos, Themistoklis A.
AU - Sokolis, Dimitrios P.
AU - Giagini, Athina T.
AU - and Davos, Constantinos H.
AU - Kakisis, John D.
AU - Kritharis,
AU - Eleftherios P.
AU - Stergiopulos, Nikos
AU - Karayannacos, Panayotis E.
AU - and Tsangaris, Sokrates
JO - IEEE Transactions on Information Technology in Biomedicine
PY - 2010
VL - 14
TODO - 3
SP - 681-690
PB - IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
SN - 1089-7771, 1558-0032
TODO - 10.1109/TITB.2010.2040288
TODO - Arteriovenous shunt; computational fluid dynamics; doppler ultrasound;
hemodynamics; intimal hyperplasia; swine model
TODO - Venous anastomotic intimal hyperplasia (IH) observed in the
arteriovenous shunt (AVS) has been associated with disturbed
hemodynamics. This study aims to correlate hemodynamics with wall
histology and wall mechanics by examining the flow field in AVS with
computational fluid dynamics using experimental data taken from in vivo
experiments. Input data to the computational model were obtained in vivo
one month after AVS creation; adjacent vessels were submitted to
histological and mechanical examination. The 3-D shunt geometry was
determined using biplane angiography. Ultrasound measurements of flow
rates were performed with perivascular flow probes and pressures were
recorded through intravascular catheters. These data were considered as
boundary conditions for calculation of the unsteady flow field.
Numerical findings are suggestive of strong Dean vortices toward both
vein flow exits, verified by color Doppler. The high wall shear stresses
(WSSs) and their gradients appear to be related to areas of IH and
vessel wall stiffening, as evidenced in preliminary histological and
mechanical studies of the venous wall. Additionally, suture line
hyperplasia seems to be aggravated by the high WSS gradients noted at
the transition line from graft to vein.
ER -