title: Microvascular stress analysis: Part II. Effects of vascular wall compliance on blood flow at the graft/recipient vessel junction.
abstract: OBJECTIVE
  To develop a finite element model (FEM) to study the effect of the vascular wall compliance on blood flow at the graft/recipient vessel junction.
  
  
  METHODS
  Finite element models of the end-to-end and end-to-side anastomoses were constructed. Simulations were performed with a computer using the finite element software NISA. The FEMs were then used to study the effects of changing the elasticity of the vascular wall on its predictions.
  
  
  RESULTS
  Deformations were relatively large; the maximum displacement for the compliant model, end-to-end anastomosis, was 55 and 88 mm for the 90-degree end-to-side anastomosis. The maximum displacement for the rigid model, end-to-end anastomosis, was 155 and 188 mm for the 90-degree end-to-side anastomosis. When the angle of inset was set at 45 degrees, there was no remarkable difference in deformation between the compliant and rigid models.
  
  
  CONCLUSIONS
  The principal stresses were remarkably less at the graft/vessel junction in models of compliant grafts and compliant vessels than for rigid wall models. The 45-degree end-to-side anastomosis seems to be the best technique when planning microvascular anastomosis for elderly patients and/or patients with systemic disease, which reduces vascular wall elasticity.
authors.affiliation: Department of Oral Surgery, Euro-Oral Hammaslääkärikeskus, Helsinki, Finland. Jalsukhun@hotmail.com
authors.forename: Jehad
authors.initials: J
authors.lastname: Al-Sukhun
authors.forename: Heikki
authors.initials: H
authors.lastname: Penttilä
authors.forename: Nureddin
authors.initials: N
authors.lastname: Ashammakhi
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D001783:Blood Flow Velocity; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D008955:Models, Cardiovascular; D012984:Software; D013314:Stress, Mechanical; D013312:Stress, Physiological; D014655:Vascular Resistance; D014656:Vascular Surgical Procedures / Q000379:methods*