Blood flows in end-to-end arteriovenous fistulas: Unsteady and steady state numerical investigations of three patient-specific cases

• Autorzy: Jodko D. , Obidowski D. , Reorowicz P. , Jóźwik K.

Identyfikatory

DOI

10.1016/j.bbe.2017.05.006

• Języki publikacji: EN

Abstrakty

EN

The arterio-venous fistula is a widely accepted vascular access for haemodialysis - a treatment for the end-stage renal disease. However, a significant number of complications (stenoses, thromboses, aneurysms) of fistulas can occur, which are related to the geometry of the anastomosis and the local abnormal hemodynamics. Local flow conditions, in particular the wall shear stress (WSS), are thought to affect sensitive endothelial cells on the inner vessel wall, which leads to intimal hyperplasia. This study presents the results obtained from numerical simulations of the blood flow through three patient-specific end-to-end fistulas which were assessed to be more likely dysfunctional than the end-to side ones. Unsteady and comparative steady-state simulations of blood flow were performed in ANSYS CFX. The obtained results show behaviour of the blood, velocity fields, shear strain, vorticity range, blood viscosity changes, a WSS distribution on vessel walls and give information about the flow rate in the veins receiving blood from fistulas. Blood flow animations are attached to the online version of the paper. Numerical methods seem to be the only opportunity to provide complete information on the distribution and range of the WSS for complicated shapes of blood vessels used to fistula creation, however the WSS is strongly dependent on the local geometry and mesh quality. High values of the shear strain, associated with elevated values of shear stress, found in each model, could increase a risk of haemolysis. High shear environment with raised vorticity can result in activation of platelets and further platelet aggregation and thrombosis.

Słowa kluczowe

EN

anastomosis; arteriovenous fistula; thrombosis; wall shear stress; vascular access

PL

przetoka tętniczo-żylna; zakrzepica; naprężenie styczne ścian; dostęp naczyniowy

• Wydawca: Nałęcz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences ; Elsevier
• Czasopismo: Biocybernetics and Biomedical Engineering
• Rocznik: 2017
• Tom: Vol. 37, no. 3
• Strony: 528--539
• Opis fizyczny: Bibliogr. 37 poz., rys., tab., wykr.

Twórcy

autor

Jodko D.

• Lodz University of Technology, Institute of Turbomachinery, 219/223 Wolczanska St, 90-924 Lodz, Poland

autor

Obidowski D.

• Lodz University of Technology, Institute of Turbomachinery, 219/223 Wolczanska St, 90-924 Lodz, Poland

autor

Reorowicz P.

• Lodz University of Technology, Institute of Turbomachinery, 219/223 Wolczanska St, 90-924 Lodz, Poland

autor

Jóźwik K.

• Lodz University of Technology, Institute of Turbomachinery, 219/223 Wolczanska St, 90-924 Lodz, Poland

Bibliografia

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Uwagi

PL

Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę (zadania 2017).