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In Vivo Validation of the In Silico Predicted Pressure Drop Across an Arteriovenous Fistula

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Abstract

The creation of an arteriovenous fistula offers a unique example of vascular remodelling and adaption. Yet, the specific factors which elicit remodelling events which determine successful maturation or failure have not been unambiguously determined. Computational fluid dynamic (CFD) simulations are increasingly been employed to investigate the interaction between local hemodynamics and remodelling and can potentially be used to assist in clinical risk assessment of maturation or failure. However, these simulations are inextricably linked to their prescribed boundary conditions and are reliant on in vivo measurements of flow and pressure to ensure their validity. The study compares in vivo measurements of the pressure distribution across arteriovenous fistulae against a representative numerical model. The results of the study indicate relative agreement (error ≈ 8–10%) between the in vivo and CFD prediction of the mean pressure drop across the AVFs. The large pressure drop across the AVFs coincided with a palpable thrill (perivascular vibration) in vivo and fluctuations were observed in the numerical pressure drop signal due to flow instabilities arising at the anastomosis. This study provides a benchmark of the pressure distribution within an AVF and validates that CFD solutions are capable of replicating the abnormal physiological flow conditions induced by fistula creation.

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Acknowledgments

The author would like to acknowledge The Irish Research Council for Science Engineering and Technology (IRCSET).

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Authors and Affiliations

  1. Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical, Aeronautical and Biomedical Engineering, Materials and Surface Science Institute, University of Limerick, Limerick, Ireland

    Leonard D. Browne, Philip Griffin, Khalid Bashar & Michael T. Walsh

  2. Department of Vascular Surgery, Limerick University Hospital, Dooradoyle, Limerick, Ireland

    Khalid Bashar & Eamon G. Kavanagh

  3. Department of Surgery, National University of Ireland, Galway, Ireland

    Stewart R. Walsh

Authors
  1. Leonard D. Browne
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  2. Philip Griffin
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  3. Khalid Bashar
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  4. Stewart R. Walsh
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  5. Eamon G. Kavanagh
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  6. Michael T. Walsh
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Corresponding author

Correspondence to Michael T. Walsh.

Additional information

Associate Editor Umberto Morbiducci oversaw the review of this article.

Electronic Supplementary Material

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10439_2015_1295_MOESM1_ESM.tif

Supplementary Figure 1. A schematic of the representative fistula model is shown. The parameters Da, Dv and α refer to the arterial diameter, vein diameter and anastomosis angle between the vessels. The variable s refers to normalised segment length and ranges from 0-1 where 0 represents the anastomosis origin and 1 represents the length of the respective vessel. Supplementary material 1 (TIFF 21417 kb)

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Browne, L.D., Griffin, P., Bashar, K. et al. In Vivo Validation of the In Silico Predicted Pressure Drop Across an Arteriovenous Fistula. Ann Biomed Eng 43, 1275–1286 (2015). https://doi.org/10.1007/s10439-015-1295-6

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  • DOI: https://doi.org/10.1007/s10439-015-1295-6

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