Spiral Laminar Flow is Associated with a Reduction in Disturbed Shear in Patient-Specific Models of an Arteriovenous Fistula

Connor V. Cunnane; J. Graeme Houston; Daniel T. Moran; Stephen P. Broderick; Rose A. Ross; Michael T. Walsh

doi:10.1007/s13239-022-00644-0

Spiral Laminar Flow is Associated with a Reduction in Disturbed Shear in Patient-Specific Models of an Arteriovenous Fistula

Connor V. Cunnane, J. Graeme Houston, Daniel T. Moran, Stephen P. Broderick, Rose A. Ross, Michael T. Walsh (Lead / Corresponding author)

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Purpose: Areas of disturbed shear that arise following arteriovenous fistula (AVF) creation are believed to contribute to the development of intimal hyperplasia (IH). The presence of helical flow can suppress areas of disturbed shear, which may protect the vasculature from IH. Therefore, the aim of this study is to determine if helical flow, specifically spiral laminar flow (SLF), is present in patient-specific AVF models and is associated with a reduction in exposure to disturbed shear.

Methods: Four AVF were imaged using MRI within the first two weeks following fistula creation. Patient-specific boundary conditions were obtained using phase-contrast MRI and applied at the inlet and outlets of each model. Computational fluid dynamics was used to analyse the hemodynamics in each model and compare the helical content of the flow to the distribution of disturbed shear.

Results: BC-1 and RC-2 are characterised by the presence of SLF, which coincides with the lowest distribution of disturbed shear. Contrastingly, SLF is absent from BC-2 and RC-1 and experience the largest amount of disturbed shear. Interestingly, BC-2 and RC-1 developed an anastomosis stenosis, while BC-1 and RC-2 remained stenosis free.

Conclusion: These findings are in agreement with previous clinical studies and further highlight the clinical potential of SLF as a prognostic marker for a healthy AVF, as its presence correlates with an overall reduction in exposure to disturbed shear and a decrease in the incidence of AVF dysfunction, albeit in a small sample size.

Original language	English
Pages (from-to)	152-165
Number of pages	14
Journal	Cardiovascular Engineering and Technology
Volume	14
Early online date	23 Sept 2022
DOIs	https://doi.org/10.1007/s13239-022-00644-0
Publication status	Published - Feb 2023

Keywords

Computational fluid dynamics
Fistula maturation
Helical flow
Pressure drop
Ultrasound imaging
Wall shear stress

ASJC Scopus subject areas

Biomedical Engineering
Cardiology and Cardiovascular Medicine

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10.1007/s13239-022-00644-0

ReDVA: Development of Hemodynamic Solutions in Renal Dialysis Venous Access Failure (Joint with Guerbet SA, University of Limerick, Vascular Flow Technologies Ltd and University Hospital Birmingham NHS Foundation Trust)
Chakraverty, S. (Investigator), Corner, G. (Investigator), Houston, G. (Investigator), Melzer, A. (Investigator), Stonebridge, P. (Investigator) & Suttie, S. (Investigator)
COMMISSION OF THE EUROPEAN COMMUNITIES
1/10/13 → 30/09/17
Project: Research

Cite this

@article{4883c5215b7e43e1821fc1cb3d673030,

title = "Spiral Laminar Flow is Associated with a Reduction in Disturbed Shear in Patient-Specific Models of an Arteriovenous Fistula",

abstract = "Purpose: Areas of disturbed shear that arise following arteriovenous fistula (AVF) creation are believed to contribute to the development of intimal hyperplasia (IH). The presence of helical flow can suppress areas of disturbed shear, which may protect the vasculature from IH. Therefore, the aim of this study is to determine if helical flow, specifically spiral laminar flow (SLF), is present in patient-specific AVF models and is associated with a reduction in exposure to disturbed shear.Methods: Four AVF were imaged using MRI within the first two weeks following fistula creation. Patient-specific boundary conditions were obtained using phase-contrast MRI and applied at the inlet and outlets of each model. Computational fluid dynamics was used to analyse the hemodynamics in each model and compare the helical content of the flow to the distribution of disturbed shear.Results: BC-1 and RC-2 are characterised by the presence of SLF, which coincides with the lowest distribution of disturbed shear. Contrastingly, SLF is absent from BC-2 and RC-1 and experience the largest amount of disturbed shear. Interestingly, BC-2 and RC-1 developed an anastomosis stenosis, while BC-1 and RC-2 remained stenosis free.Conclusion: These findings are in agreement with previous clinical studies and further highlight the clinical potential of SLF as a prognostic marker for a healthy AVF, as its presence correlates with an overall reduction in exposure to disturbed shear and a decrease in the incidence of AVF dysfunction, albeit in a small sample size.",

keywords = "Computational fluid dynamics, Fistula maturation, Helical flow, Pressure drop, Ultrasound imaging, Wall shear stress",

author = "Cunnane, {Connor V.} and Houston, {J. Graeme} and Moran, {Daniel T.} and Broderick, {Stephen P.} and Ross, {Rose A.} and Walsh, {Michael T.}",

note = "Copyright: {\textcopyright} 2022, The Author(s) under exclusive licence to Biomedical Engineering Society.",

year = "2023",

month = feb,

doi = "10.1007/s13239-022-00644-0",

language = "English",

volume = "14",

pages = "152--165",

journal = "Cardiovascular Engineering and Technology",

issn = "1869-408X",

publisher = "Springer Verlag",

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T1 - Spiral Laminar Flow is Associated with a Reduction in Disturbed Shear in Patient-Specific Models of an Arteriovenous Fistula

AU - Cunnane, Connor V.

AU - Houston, J. Graeme

AU - Moran, Daniel T.

AU - Broderick, Stephen P.

AU - Ross, Rose A.

AU - Walsh, Michael T.

PY - 2023/2

Y1 - 2023/2

N2 - Purpose: Areas of disturbed shear that arise following arteriovenous fistula (AVF) creation are believed to contribute to the development of intimal hyperplasia (IH). The presence of helical flow can suppress areas of disturbed shear, which may protect the vasculature from IH. Therefore, the aim of this study is to determine if helical flow, specifically spiral laminar flow (SLF), is present in patient-specific AVF models and is associated with a reduction in exposure to disturbed shear.Methods: Four AVF were imaged using MRI within the first two weeks following fistula creation. Patient-specific boundary conditions were obtained using phase-contrast MRI and applied at the inlet and outlets of each model. Computational fluid dynamics was used to analyse the hemodynamics in each model and compare the helical content of the flow to the distribution of disturbed shear.Results: BC-1 and RC-2 are characterised by the presence of SLF, which coincides with the lowest distribution of disturbed shear. Contrastingly, SLF is absent from BC-2 and RC-1 and experience the largest amount of disturbed shear. Interestingly, BC-2 and RC-1 developed an anastomosis stenosis, while BC-1 and RC-2 remained stenosis free.Conclusion: These findings are in agreement with previous clinical studies and further highlight the clinical potential of SLF as a prognostic marker for a healthy AVF, as its presence correlates with an overall reduction in exposure to disturbed shear and a decrease in the incidence of AVF dysfunction, albeit in a small sample size.

AB - Purpose: Areas of disturbed shear that arise following arteriovenous fistula (AVF) creation are believed to contribute to the development of intimal hyperplasia (IH). The presence of helical flow can suppress areas of disturbed shear, which may protect the vasculature from IH. Therefore, the aim of this study is to determine if helical flow, specifically spiral laminar flow (SLF), is present in patient-specific AVF models and is associated with a reduction in exposure to disturbed shear.Methods: Four AVF were imaged using MRI within the first two weeks following fistula creation. Patient-specific boundary conditions were obtained using phase-contrast MRI and applied at the inlet and outlets of each model. Computational fluid dynamics was used to analyse the hemodynamics in each model and compare the helical content of the flow to the distribution of disturbed shear.Results: BC-1 and RC-2 are characterised by the presence of SLF, which coincides with the lowest distribution of disturbed shear. Contrastingly, SLF is absent from BC-2 and RC-1 and experience the largest amount of disturbed shear. Interestingly, BC-2 and RC-1 developed an anastomosis stenosis, while BC-1 and RC-2 remained stenosis free.Conclusion: These findings are in agreement with previous clinical studies and further highlight the clinical potential of SLF as a prognostic marker for a healthy AVF, as its presence correlates with an overall reduction in exposure to disturbed shear and a decrease in the incidence of AVF dysfunction, albeit in a small sample size.

KW - Computational fluid dynamics

KW - Fistula maturation

KW - Helical flow

KW - Pressure drop

KW - Ultrasound imaging

KW - Wall shear stress

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DO - 10.1007/s13239-022-00644-0

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AN - SCOPUS:85138691340

SN - 1869-408X

VL - 14

SP - 152

EP - 165

JO - Cardiovascular Engineering and Technology

JF - Cardiovascular Engineering and Technology

ER -

Spiral Laminar Flow is Associated with a Reduction in Disturbed Shear in Patient-Specific Models of an Arteriovenous Fistula

Abstract

Keywords

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Projects

ReDVA: Development of Hemodynamic Solutions in Renal Dialysis Venous Access Failure (Joint with Guerbet SA, University of Limerick, Vascular Flow Technologies Ltd and University Hospital Birmingham NHS Foundation Trust)

Cite this