title: Computational model for simulation of vascular adaptation following vascular access surgery in haemodialysis patients.
abstract: An important number of surgical procedures for creation of vascular access (VA) in haemodialysis patients still results in non-adequate increase in blood flow (non-maturation). The rise in blood flow in arteriovenous shunts depends on vascular remodelling. Computational tools to predict the outcome of VA surgery would be important in this clinical context. The aim of our investigation was then to develop a 0D/1D computational model of arm vasculature able to simulate vessel wall remodelling and related changes in blood flow. We assumed that blood vessel remodelling is driven by peak wall shear stress. The model was calibrated with previously reported values of radial artery diameter and blood flow after end-to-end distal fistula creation. Good agreement was obtained between predicted changes in VA flow and in arterial diameter after surgery and corresponding measured values. The use of this computational model may allow accurate vascular surgery planning and ameliorate VA surgery outcomes.
authors.affiliation: a Department of Biomedical Engineering , Mario Negri Institute for Pharmacological Research , Bergamo , Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Manini
authors.forename: Katia
authors.initials: K
authors.lastname: Passera
authors.forename: Wouter
authors.initials: W
authors.lastname: Huberts
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Botti
authors.forename: Luca
authors.initials: L
authors.lastname: Antiga
authors.forename: Andrea
authors.initials: A
authors.lastname: Remuzzi
mesh_terms: D000222:Adaptation, Physiological; D000465:Algorithms; D001132:Arm / Q000098:blood supply; D001166:Arteriovenous Shunt, Surgical; D003198:Computer Simulation; D006439:Hemodynamics; D006801:Humans; D008955:Models, Cardiovascular; D017534:Radial Artery / Q000502:physiology / Q000601:surgery; D006435:Renal Dialysis; D013314:Stress, Mechanical
keywords: anastomosis; blood flow adaptation; haemodialysis; vascular access; wall shear stress