Search

Purpose: The aim of this study was to investigate the blood flow in the end-to-side arteriovenous (a-v) fistula, taking into account its pulsating nature and the patient-specific geometry of blood vessels. Computational Fluid Dynamics (CFD) methods were used for this analysis. Methods: DICOM images of the fistula, obtained from the angio-computed tomography, were a source of the data applied to develop a 3D geometrical model of the fistula. The model was meshed, then the ANSYS CFX v. 15.0 code was used to perform simulations of the flow in the vessels under analysis. Mesh independence tests were conducted. The non-Newtonian rheological model of blood and the Shear Stress Transport model of turbulence were employed. Blood vessel walls were assumed to be rigid. Results: Flow patterns, velocity fields, the volume flow rate, the wall shear stress (WSS) propagation on particular blood vessel walls were shown versus time. The maximal value of the blood velocity was identified in the anastomosis - the place where the artery is connected to the vein. The flow rate was calculated for all veins receiving blood. Conclusions: The blood flow in the geometrically complicated a-v fistula was simulated. The values and oscillations of the WSS are the largest in the anastomosis, much lower in the artery and the lowest in the cephalic vein. A strong influence of the mesh on the results concerning the maximal and area-averaged WSS was shown. The relation between simulations of the pulsating and stationary flow under time-averaged flow conditions was presented. [ABSTRACT FROM AUTHOR]

The Ciminio-Brescia arterio-venous fistula is a preferred vascular access for haemodialysis, but it is often associated with the development of vascular complications, due to changes in hemodynamic conditions. Computational fluid dynamics methods were involved to carry out seven simulations of the blood flow through the fistula for the patient specific (geometrical) case and various boundary conditions. The geometrical data, obtained from the angio-computed tomography, were used to create a 3-dimensional CAD model of the fistula. The blood flow patterns, blood velocity and the wall shear stress, thought to play a key role in the development of typical complications (stenoses, thromboses, aneurysms, etc.), have been analyzed in this study. The blood flow is reversed locally downstream the anastomosis (where the artery is connected to the vein) and downstream the stenosis in the cannulated vein. Blood velocity reaches abnormal value in the anastomosis during the systolic phase of the cardiac cycle (2.66 m/s). The wall shear stress changes in this place during a single cycle of the heart operation from 27.9 to 71.3 Pa (average 41.5 Pa). The results are compared with data found in the literature. [ABSTRACT FROM AUTHOR]