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A Computational Analysis of the Influence of Anastomosis Angle on Stenosis-Prone Locations during Radio-Cephalic Arteriovenous Fistula Maturation

A Computational Analysis of the Influence of Anastomosis Angle on Stenosis-Prone Locations during Radio-Cephalic Arteriovenous Fistula Maturation
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摘要 In dialysis treatment, the radio-cephalic arteriovenous fistula (RCAVF) is a commonly used fistula, yet its low maturation rate remains a challenge. To enhance surgical outcomes, the relationship between stenosis-prone locations and RCAVF anastomosis angle is studied during maturation by developing two sets of RCAVF models for early (non-mature) and mature RCAVFs at five anastomosis angles. The impact of hemodynamics and wall shear stress (WSS) is examined to determine optimal anastomotic angles. Results indicate that acute angles produce more physiological WSS distributions and fewer disturbed regions, with early stenosis-prone regions located near the anastomosis that shift to the bending venous segment during remodeling. A pilot study comparing clinical and numerical results is conducted for validation. In dialysis treatment, the radio-cephalic arteriovenous fistula (RCAVF) is a commonly used fistula, yet its low maturation rate remains a challenge. To enhance surgical outcomes, the relationship between stenosis-prone locations and RCAVF anastomosis angle is studied during maturation by developing two sets of RCAVF models for early (non-mature) and mature RCAVFs at five anastomosis angles. The impact of hemodynamics and wall shear stress (WSS) is examined to determine optimal anastomotic angles. Results indicate that acute angles produce more physiological WSS distributions and fewer disturbed regions, with early stenosis-prone regions located near the anastomosis that shift to the bending venous segment during remodeling. A pilot study comparing clinical and numerical results is conducted for validation.
作者 Yang Yang Pascale Kulisa Benyebka Bou-Saïd Mahmoud El Hajem Serge Simoens Nellie Della Schiava Yang Yang;Pascale Kulisa;Benyebka Bou-Saïd;Mahmoud El Hajem;Serge Simoens;Nellie Della Schiava(CNRS, INSA de Lyon, LaMCoS, University of Lyon, Villeurbanne, France;INSA Lyon, CNRS, Ecole Centrale de Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Villeurbanne, France;State Key Laboratory of Solidification Processing, Center of Advanced Lubrication and Seal Materials, Northwestern Poytechnical University, Xi’an, China;CNRS, Ecole Centrale de Lyon, INSA Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Ecully, France;Department of Vascular Surgery, Hospices Civils de Lyon, Lyon, France)
出处 《Journal of Biomedical Science and Engineering》 2023年第6期81-93,共13页 生物医学工程(英文)
关键词 Radio-Cephalic Arteriovenous Fistula (RCAVF) Anastomosis Angle MATURATION Wall Shear Stress Distribution Stenosis-Prone Locations Radio-Cephalic Arteriovenous Fistula (RCAVF) Anastomosis Angle Maturation Wall Shear Stress Distribution Stenosis-Prone Locations
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