Document Detail


Effect of tapered grafts on hemodynamics and flow rate in dialysis access grafts.
MedLine Citation:
PMID:  15209854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Aside from the high incidence of venous stenosis, high-output failure and peripheral steal syndromes remain serious problems of vascular access. Meanwhile commercial tapered grafts are available to address this topic, but little is known about its effect neither on graft flow nor on hemodynamics. METHODS: Anastomotic models were constructed using a clear silicon elastomer. The arterial anastomosis was shaped in two ways: 1) like a direct connection of artery and 7-mm graft and 2) with a 4-mm diameter segment between artery and graft. Hemodynamic measurements were performed in a pulsatile flow circuit to simulate blood flow at physiological conditions. Flow patterns were obtained by direct dye injection. Additionally, the correlation between the length of narrow segment and mean arterial pressure was investigated. RESULTS: In all models using a 4-mm segment, the oscillating anastomotic vortex was disappeared. This vortex was shifted to the area behind the well-rounded expansions of the graft demonstrating a new separation region, but the flow direction was constant during the whole simulated cycle. At identical pressure rates and waveforms the length of narrow segment determined the graft flow rate directly (e.g., at mean pressure 100 mmHg, flow reduction up to 28% in 4-mm segments, and up to 55% in 3-mm segments). CONCLUSION: These findings indicate that taper is an important consideration in the design of vascular access grafts.
Authors:
Ulf Krueger; Almuth Huhle; Kerstin Krys; Hans Scholz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  28     ISSN:  0160-564X     ISO Abbreviation:  Artif Organs     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-22     Completed Date:  2004-09-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  623-8     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Queen Elisabeth Hospital, Berlin, Germany. U.krueger@keh-berlin.de
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MeSH Terms
Descriptor/Qualifier:
Arteriovenous Shunt, Surgical
Blood Flow Velocity
Blood Vessel Prosthesis*
Hemodynamics
Humans
Models, Cardiovascular
Prosthesis Design
Pulsatile Flow
Renal Dialysis
Silicone Elastomers
Chemical
Reg. No./Substance:
0/Silicone Elastomers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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