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Distinct Temporal Pattern of the Prediction of Lumen Remodeling of Lower Extremity Vein Bypass Grafts by Initial Local Hemodynamics

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Abstract

We predicted human lower extremity vein bypass graft remodeling by hemodynamics. Computed tomography and duplex ultrasound scans of 55 patients were performed at 1 week and 1, 6, and 12 months post-implantation to obtain wall shear stress (WSS) and oscillatory shear index (OSI) at 1-mm intervals via computational fluid dynamics simulations. Graft remodeling was quantified by computed tomography-measured lumen diameter changes in the early (1 week-1 month), intermediate (1–6 months), and late (6–12 months) periods. Linear mixed-effect models were constructed to examine the overall relationship between remodeling and initial hemodynamics using the average data of all cross sections within the same graft. A significant association of graft remodeling with WSS (p < 0.001) and time (p = 0.001) was found; however, the effect size decreased with time (every 2.7 dyne/cm2 increase of WSS was associated with a 0.39, 0.35, 0.002 mm diameter increase in the three periods, respectively). The association of remodeling with OSI was significant only in the intermediate period (every 0.1 increase of OSI was associated with a 0.25 mm lumen diameter decrease, p = 0.004). Therefore, the association of graft lumen remodeling with local hemodynamics has a distinct temporal pattern; WSS and OSI are predictive of remodeling only in certain postoperative periods.

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Acknowledgements

This study was funded by the U.S. Veterans Affairs Clinical Science Research and Development Merit Review Grant (S.A.B.) and the National Institutes of Health Grant 1K23HL084090 (Peter R Nelson).

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The authors have no professional or financial conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, University of Florida, PO Box 100128, Gainesville, FL, 32610-0286, USA

    Yong He & Scott A. Berceli

  2. The Vascular Surgery Section, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, USA

    Yong He & Scott A. Berceli

  3. Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA

    Roger Tran-Son-Tay

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  1. Yong He
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Correspondence to Yong He.

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Associate Editor Jane Grande-Allen oversaw the review of this article.

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He, Y., Tran-Son-Tay, R. & Berceli, S.A. Distinct Temporal Pattern of the Prediction of Lumen Remodeling of Lower Extremity Vein Bypass Grafts by Initial Local Hemodynamics. Ann Biomed Eng 51, 296–307 (2023). https://doi.org/10.1007/s10439-022-03019-7

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