Τίτλος:
Biomechanical, morphological and zero-stress state characterization of
jugular vein remodeling in arteriovenous fistulas for hemodialysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
While the role of hemodynamic variables on the development of intimal
hyperplasia in arteriovenous fistulas for hemodialysis has been
examined, less is known about the intramural biomechanical factors. In
this study, arteriovenous fistulas were created by implantation of
e-PTFE grafts between carotid artery and jugular vein in healthy pigs.
In vivo recordings exhibited a three-fold pressure and flow elevation in
grafted veins after fistula creation, remaining so until sacrifice. The
chief morphological observation in grafted vessels was wall thickening
at two weeks, serving to restore intramural stresses to homeostatic
levels, and a less marked internal diameter enlargement, gradually
normalizing intimal shear after four weeks. The residual strains and
opening angle, specifying the zero-stress configuration, increased with
differences reaching significance at twelve weeks. Association with
histomorphological findings on intima, media and adventitia growth
disclosed a correlation between intimal hyperplasia and opening angle
increase. Elastin and cellular contents diminished opposite to collagen
content, most differences occurring within the first four weeks after
grafting. Inflation/extension testing showed that post-fistula the vein
wall became progressively thicker and stiffer, lacking restoration of
compliance to baseline levels. The present data may further our
understanding of the dynamics of venous biomechanical remodeling under
pressure and flow-overload conditions.
Συγγραφείς:
Kritharis, Eleftherios P.
Kakisis, John D.
Giagini, Athina T.
and Manos, Themistoklis
Stergiopulos, Nikos
Tsangaris, Sokrates
and Sokolis, Dimitrios P.
Λέξεις-κλειδιά:
e-PTFE distal vein anastomosis; histology; shear stress; intramural
stress; residual stress
DOI:
10.3233/BIR-2011-0578
