title: Microvascular stress analysis. Part I: simulation of microvascular anastomoses using finite element analysis.
abstract: OBJECTIVE
  To develop a finite element model (FEM) to study the effect of the stress and strain, in microvascular anastomoses that result from the geometrical mismatch of anastomosed vessels.
  
  
  METHODS
  FEMs of end-to-end and end-to-side anastomoses were constructed. Simulations were made using finite element software (NISA). We investigated the angle of inset in the end-to-side anastomosis and the discrepancy in the size of the opening in the vessel between the host and recipient vessels. The FEMs were used to predict principal and shear stress and strain at the position of each node.
  
  
  RESULTS
  Two types of vascular deformation were predicted during different simulations: longitudinal distortion, and rotational distortion. Stress values ranged from 151.1 to 282.4MPa for the maximum principal stress, from -122.9 to -432.2MPa for the minimum principal stress, and from 122.1 to 333.1MPa for the maximum shear stress. The highest values were recorded when there was a 50% mismatch in the diameter of the vessels at the site of the end-to-end anastomosis.
  
  
  CONCLUSIONS
  The effect of the vessel's size discrepancy on the blood flow and deformation was remarkable in the end-to-end anastomosis. End-to-side anastomosis was superior to end-to-end anastomosis. FEM is a powerful tool to study vascular deformation, as it predicts deformation and biomechanical processes at sites where physical measurements are likely to remain impossible in living humans.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, Kasarmikatu 11-13, PO Box 263, 00029 HUS, Helsinki, Finland. Jalsukhun@hotmail.com
authors.forename: Jehad
authors.initials: J
authors.lastname: Al-Sukhun
authors.forename: Christian
authors.initials: C
authors.lastname: Lindqvist
authors.forename: Nureddin
authors.initials: N
authors.lastname: Ashammakhi
authors.forename: Heikki
authors.initials: H
authors.lastname: Penttilä
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D001808:Blood Vessels / Q000033:anatomy & histology*; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D008833:Microcirculation; D008955:Models, Cardiovascular; D012986:Software Validation; D013314:Stress, Mechanical; D013312:Stress, Physiological / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods