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

Jodko D., Obidowski D., Reorowicz P., Jóźwik K.

Biocybernetics and Biomedical Engineering

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2017

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Vol. 37, no. 3

528--539

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.

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Numerical investigations of the unsteady blood flow in the end-to-side arteriovenous fistula for hemodialysis

Jodko D., Obidowski D., Reorowicz P., Jóźwik K.

Acta of Bioengineering and Biomechanics

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2016

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Vol. 18, no. 4

3--13

EN

Purpose: The aim of this study was to investigate the blood flow in the end-to-side arteriovenous (a-v) fistula, taking into account its pulsating nature and the patient-specific geometry of blood vessels. Computational Fluid Dynamics (CFD) methods were used for this analysis. Methods: DICOM images of the fistula, obtained from the angio-computed tomography, were a source of the data applied to develop a 3D geometrical model of the fistula. The model was meshed, then the ANSYS CFX v. 15.0 code was used to perform simulations of the flow in the vessels under analysis. Mesh independence tests were conducted. The non-Newtonian rheological model of blood and the Shear Stress Transport model of turbulence were employed. Blood vessel walls were assumed to be rigid. Results: Flow patterns, velocity fields, the volume flow rate, the wall shear stress (WSS) propagation on particular blood vessel walls were shown versus time. The maximal value of the blood velocity was identified in the anastomosis – the place where the artery is connected to the vein. The flow rate was calculated for all veins receiving blood. Conclusions: The blood flow in the geometrically complicated a-v fistula was simulated. The values and oscillations of the WSS are the largest in the anastomosis, much lower in the artery and the lowest in the cephalic vein. A strong influence of the mesh on the results concerning the maximal and area-averaged WSS was shown. The relation between simulations of the pulsating and stationary flow under time-averaged flow conditions was presented.

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Dobór cech diagnostycznych dla klasyfikatora SVM w zadaniu klasyfikacji stanu przetoki tętniczo-żylnej na podstawie sygnału akustycznego

Grochowina M., Leniowska L.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2016

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Vol. 22, nr 4

207--212

PL

W artykule przedstawiono proces selekcji cech diagnostycznych dla klasyfikatora SVM. Badania przeprowadzone zostały z użyciem zbioru danych zawierającego próbki sygnału dźwiękowego emitowanego przez przetokę tętniczo-żylną. Celem prac było stworzenie rozwiązania klasyfikacji wieloklasowej w oparciu o klasyfikator z rodziny SVM pozwalającego na skuteczną i wiarygodną ocenę stanu przetoki tętniczo-żylnej.

EN

The paper presents the process of selection diagnostic features for SVM classifier. The study was conducted with using a data set containing samples of the sound signal emitted by the arteriovenous fistula. The objective was to create a solution multi-class classification based on SVM classifier family allowing for an effective and reliable evaluation of the arteriovenous fistula state.