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Jeffrey E. Hull, MD, Boris V. Balakin, PhD, Brad M

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Presentation on theme: "Jeffrey E. Hull, MD, Boris V. Balakin, PhD, Brad M"— Presentation transcript:

1 Computational fluid dynamic evaluation of the side-to-side anastomosis for arteriovenous fistula 
Jeffrey E. Hull, MD, Boris V. Balakin, PhD, Brad M. Kellerman, BSc, David K. Wrolstad, BSc  Journal of Vascular Surgery  Volume 58, Issue 1, Pages e1 (July 2013) DOI: /j.jvs Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Pressure drop across anastomoses at flow rates of 600 to 1200 mL/min in 4 + 6 artery-vein pair models in three configurations (side-to-side [STS] and 45° and 90° end-to-side [ETS]) and two sizes of anastomosis (4.5 × 1.5 and 6.0 × 4.0 mm). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Histograms of flow at an inlet pressure of 100 mm Hg showing arterial inflow (Ai), arterial outflow (Ao), and proximal venous outflow (Vo), in milliliters per minute, with side-to-side (STS) and 45° and 90° end-to-side (ETS) configurations of 3.0 × 1.5-, 4.5 × 1.5-, and 6.0 × 4.0-mm anastomoses. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Paired velocity vector and wall shear stress (WSS) diagrams of side-to-side (STS) anastomoses at a constant flow rate of 900 mL/min. A-C, 3 + 3 vein-pair models of 3.0- × 1.5-mm, 4.5- × 1.5-mm, and 6.0- × 1.5-mm anastomoses, respectively. D-F, 4 + 6 vein-pair models of 3.0- × 1.5-mm, 4.5- × 1.5-mm, and 6.0- × 1.5-mm anastomoses, respectively. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Paired velocity vector and wall shear stress (WSS) diagrams at a constant flow rate of 900 mL/min for 4 + 6 vein-pair models of side-to-side (STS) (A) and 45° (B) and 90° (C) end-to-side (ETS) anastomoses 6.0 × 4.0 mm in size. Note the uniform WSS in the STS configuration (A) compared with the marked variance in WSS in the 45° and 90° ETS configurations. The areas of low WSS (blue) adjacent to high WSS (green/yellow/red) in the proximal venous outflow of the 45° and 90° ETS configurations are prone to intimal hyperplasia. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

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