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Computational model for simulation of vascular adaptation following vascular access surgery in haemodialysis patients |
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| Authors: | Simone Manini Katia Passera Wouter Huberts Lorenzo Botti Luca Antiga Andrea Remuzzi |
| Institution: | 1. Department of Biomedical Engineering, Mario Negri Institute for Pharmacological Research, Bergamo, Italy;2. Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands;3. Department of Biomedical Engineering, Maastricht University Medical Center, Maastricht, The Netherlands;4. Department of Industrial Engineering, University of Bergamo, Bergamo, Italy;5. Orobix Srl, Bergamo, Italy;6. Department of Industrial Engineering, University of Bergamo, Bergamo, Italy |
| Abstract: | An important number of surgical procedures for creation of vascular access (VA) in haemodialysis patients still results in non-adequate increase in blood flow (non-maturation). The rise in blood flow in arteriovenous shunts depends on vascular remodelling. Computational tools to predict the outcome of VA surgery would be important in this clinical context. The aim of our investigation was then to develop a 0D/1D computational model of arm vasculature able to simulate vessel wall remodelling and related changes in blood flow. We assumed that blood vessel remodelling is driven by peak wall shear stress. The model was calibrated with previously reported values of radial artery diameter and blood flow after end-to-end distal fistula creation. Good agreement was obtained between predicted changes in VA flow and in arterial diameter after surgery and corresponding measured values. The use of this computational model may allow accurate vascular surgery planning and ameliorate VA surgery outcomes. |
| Keywords: | vascular access haemodialysis blood flow adaptation anastomosis wall shear stress |