0

Full Content is available to subscribers

Subscribe/Learn More  >

Longitudinal Effect of Pressure Drop on the Intima-Media Thickening of the Venous Segment of the Arteriovenous Fistula

[+] Author Affiliations
Ehsan Rajabi-Jaghargh, Mahesh K. Krishnamoorthy, Rupak K. Banerjee

University of Cincinnati, Cincinnati, OH

Paper No. SBC2013-14478, pp. V01AT13A017; 2 pages
doi:10.1115/SBC2013-14478
From:
  • ASME 2013 Summer Bioengineering Conference
  • Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotransport Phenomena; Bone, Joint and Spine Mechanics; Brain Injury; Cardiac Mechanics; Cardiovascular Devices, Fluids and Imaging; Cartilage and Disc Mechanics; Cell and Tissue Engineering; Cerebral Aneurysms; Computational Biofluid Dynamics; Device Design, Human Dynamics, and Rehabilitation; Drug Delivery and Disease Treatment; Engineered Cellular Environments
  • Sunriver, Oregon, USA, June 26–29, 2013
  • Conference Sponsors: Bioengineering Division
  • ISBN: 978-0-7918-5560-7
  • Copyright © 2013 by ASME

abstract

Venous stenosis is one of the primary causes of the arteriovenous fistula (AVF) maturation-failure and is characterized by vasoconstriction and significant intima-media thickening (IMT). Although the hemodynamic endpoints are believed to play a crucial role in the pathogenesis of venous stenosis, the exact mechanism behind this is unclear. Our hypothesis is that the changes in the pressure drop over time (Δp′) can influence the remodeling factors in AVFs: changes in luminal diameter (ΔDh) and IMT. Curved (C-AVF; n = 3) and straight (S-AVF; n = 3) AVFs were created between the femoral arteries and veins of 3 pigs. CT-scan and ultrasound were utilized to numerically evaluate the flow field, and thus pressure drop in AVFs at 2D (D: days), 7D, and 28D post-surgery. For each AVF, IMT was also measured at 4 histological blocks along the vein. For the C-AVF, the pressure drop consistently decreased over time (from 18.32 mmHg at 2D to 4.58 mmHg at 28D), while opposite trend was found for the S-AVF (from 12.91 mmHg at 2D to 24.49 mmHg at 28D). The Δp′ was negative at all the histology blocks for C-AVF which showed the reduction in the resistance over time due to dilation (positive ΔDh) and outward hypertrophy of the venous segment (positive ΔDh/IMT). In contrast, Δp′ was mostly positive for the S-AVF which showed the increase in the resistance due to vasoconstriction (negative ΔDh) and inward hypertrophy (negative ΔDh/IMT). Thus, measuring Δp′ at the successive post-surgery time points can provide important information on the remodeling behavior of AVFs. Also, creating AVFs in a surgical configuration that can result in negative Δp′ and thus favorable remodeling could influence the life expectancy of the dialysis patients.

Copyright © 2013 by ASME
Topics: Pressure drop

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In