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Angioplasty Induced Changes in Dialysis Vascular Access Compliance

Annals of Biomedical Engineering volume 49, pages 2635–2645 (2021)Cite this article

Abstract

Dialysis vascular access remains vitally important to maintain life and functional capacity with end stage renal disease. Angioplasty is an integral part of maintaining dialysis access function and patency. To understand the effect of angioplasty balloon dilation on vascular wall mechanics, we conducted a clinical study to evaluate the elastic modulus of the anastomosis in five subjects with anastomosis stenoses, before and after six angioplasty procedures, using B-mode ultrasound DICOM data. A novel and open source vascular ultrasound high-resolution speckle tracking software tool was used. The median lumen diameter increased from 3.4 to 5.5 mm after angioplasty. Meanwhile, the median elastic modulus of the 18 measurements at the anastomosis increased by 52.2%, from 2.24 × 103 to 3.41 × 103 mmHg. The results support our hypothesis that the structural changes induced in the vessel wall by balloon dilation lead to reduced vascular compliance and a higher elastic modulus of the vessel wall.

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Acknowledgments

This work was supported in part by the United States Office of Veterans Affairs Grant Number 5I01RX002271.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA, 01609, USA

    Yihao Zheng

  2. VA Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Yihao Zheng, Brian J. Thelen, Nirmala Rajaram, Venkataramu N. Krishnamurthy, James Hamilton, Timothy Morgan, Lenar Yessayan, Brandie Bishop, Nickolas Osborne, Peter Henke & William F. Weitzel

  3. Department of Statistics, University of Michigan, Ann Arbor, MI, USA

    Brian J. Thelen

  4. Michigan Tech Research Institute, Michigan Technological University, Ann Arbor, MI, USA

    Brian J. Thelen

  5. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

    Nirmala Rajaram

  6. Departments of Radiology and Surgery, University of Michigan, Ann Arbor, MI, USA

    Venkataramu N. Krishnamurthy

  7. Emerge Now Inc., Los Angeles, CA, USA

    James Hamilton

  8. Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA

    Miguel Angel Funes-Lora & Albert J. Shih

  9. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Lenar Yessayan, Nickolas Osborne, Peter Henke & William F. Weitzel

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  1. Yihao Zheng
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Correspondence to Yihao Zheng.

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Zheng, Y., Thelen, B.J., Rajaram, N. et al. Angioplasty Induced Changes in Dialysis Vascular Access Compliance. Ann Biomed Eng 49, 2635–2645 (2021). https://doi.org/10.1007/s10439-021-02844-6

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  • DOI: https://doi.org/10.1007/s10439-021-02844-6

Keywords

  • Arteriovenous fistula
  • Angioplasty
  • Vascular compliance
  • Elastic modulus
  • Ultrasound
  • Speckle tracking

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