Annals of Biomedical Engineering

, Volume 45, Issue 6, pp 1449–1461 | Cite as

Hemodynamic Characterization of Peripheral Arterio-venous Malformations

  • Sabrina Frey
  • A. Haine
  • R. Kammer
  • H. von Tengg-Kobligk
  • D. Obrist
  • I. Baumgartner


Peripheral arterio-venous malformations (pAVMs) are congenital vascular anomalies that require treatment, due to their severe clinical consequences. The complexity of lesions often leads to misdiagnosis and ill-planned treatments. To improve disease management, we developed a computational model to quantify the hemodynamic effects of key angioarchitectural features of pAVMs. Hemodynamic results were used to predict the transport of contrast agent (CA), which allowed us to compare our findings to digital subtraction angiography (DSA) recordings of patients. The model is based on typical pAVM morphologies and a generic vessel network that represents realistic vascular feeding and draining components related to lesions. A lumped-parameter description of the vessel network was employed to compute blood pressure and flow rates. CA-transport was determined by coupling the model to a 1D advection–diffusion equation. Results show that the extent of hemodynamic effects of pAVMs, such as arterial steal and venous hypertension, strongly depends on the lesion type and its vascular architecture. Dimensions of shunting vessels strongly influence hemodynamic parameters. Our results underline the importance of the dynamics of CA-transport in diagnostic DSA images. In this context, we identified a set of temporal CA-transport parameters, which are indicative of the presence and specific morphology of pAVMs.


Lumped parameter model Blood flow modelling Contrast agent transport 1D advection–diffusion Yakes AVM classification Vascular malformations 



Arterio-venous malformation


Cerebral arterio-venous malformation


Peripheral arterio-venous malformation


Magnetic resonance


Digital subtraction angiography


Contrast agent


Lumped parameter model


Anterior tibial artery


Posterior tibial artery


Fibular artery


Medial and dorsal arteries in the foot


Digital arteries in the foot


Digital veins in the foot


Medial and dorsal veins in the foot


Posterior tibial vein


Anterior tibial vein


Fibular vein


Great saphenous vein


Small saphenous vein


Cardiac output


Conflict of interest


Supplementary material

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Supplementary material 1 (EPS 1141 kb)
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Supplementary material 2 (EPS 1037 kb)
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Supplementary material 3 (EPS 1106 kb)


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Copyright information

© Biomedical Engineering Society 2017

Authors and Affiliations

  1. 1.ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
  2. 2.Division of Angiology, Swiss Cardiovascular CenterUniversity of Bern, Bern University HospitalBernSwitzerland
  3. 3.Department of Diagnostic, Interventional and Pediatric RadiologyUniversity of Bern, Bern University HospitalBernSwitzerland

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