title: The influence of the anastomosis angle on the hemodynamics in the distal anastomosis in the infrainguinal bypass: an in vitro study.
abstract: The geometric shape of the distal anastomosis in an infrainguinal bypass has an influence on its durability. In this article, we compared three different angles of the anastomosis with regard to the hemodynamics. Three experimental models of the distal infrainguinal anastomosis with angles of 25°, 45°, and 60° respectively were constructed according to the similarity theory to assess flow in the anastomoses using particle image velocimetry and computational fluid dynamics. In the toe, heel, and floor of the anastomosis that correspond to the locations worst affected by intimal hyperplasia, adverse blood flow and wall shear stress were observed in the 45° and 60° models. In the 25° model, laminar blood flow was apparent more peripherally from the anastomosis. In conclusions, decreasing the distal anastomosis angle in a femoropopliteal bypass results in more favorable hemodynamics including the flow pattern and wall shear stress in locations susceptible to intimal hyperplasia.
authors.affiliation: Second Department of Surgery, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; Department of Radiology, General University Hospital in Prague, Prague, Czech Republic. lambert.lukas@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Grus
authors.forename: G
authors.initials: G
authors.lastname: Grusová
authors.forename: L
authors.initials: L
authors.lastname: Lambert
authors.forename: R
authors.initials: R
authors.lastname: Banerjee
authors.forename: J
authors.initials: J
authors.lastname: Matěcha
authors.forename: M
authors.initials: M
authors.lastname: Mlček
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D006439:Hemodynamics; D018056:Hemorheology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D014656:Vascular Surgical Procedures / Q000379:methods*