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A Computational Analysis of the Influence of Anastomosis Angle on Stenosis-Prone Locations during Radio-Cephalic Arteriovenous Fistula Maturation
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
INSA Lyon, CNRS, Ecole Centrale de Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Villeurbanne, France
Department of Vascular Surgery, Hospices Civils de Lyon, Lyon, France
- 1 CNRS, INSA de Lyon, LaMCoS, University of Lyon, Villeurbanne, France
- 2 INSA Lyon, CNRS, Ecole Centrale de Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Villeurbanne, France
- 3 State Key Laboratory of Solidification Processing, Center of Advanced Lubrication and Seal Materials, Northwestern Poytechnical University, Xi’an, China
- 4 CNRS, Ecole Centrale de Lyon, INSA Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Ecully, France
- 5 INSA Lyon, CNRS, Ecole Centrale de Lyon, Univ Claude Bernard Lyon 1, LMFA, University of Lyon, Villeurbanne, France
- 6 Department of Vascular Surgery, Hospices Civils de Lyon, Lyon, France
Journal of Biomedical Science and Engineering·Volume 16 (2023)·Pages 81–93·Published 27 July 2023·DOI10.4236/jbise.2023.166006
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Abstract
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.
KeywordsRadio-Cephalic Arteriovenous Fistula (RCAVF)Anastomosis AngleMaturationWall Shear Stress DistributionStenosis-Prone Locations
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