Document Detail


Numerical investigation of the haemodynamics at a patched arterial bypass anastomosis.
MedLine Citation:
PMID:  12135648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intimal hyperplasia at arterial bypass graft anastomoses is a major factor responsible for graft failure. A revised surgical technique, incorporating a Taylor vein patch into the distal anastomosis of PTFE grafts, results in a decrease in intimal hyperplasia and improved patency rates. Numerical simulations of pulsatile, non-Newtonian blood flow through life-like femorodistal bypass models have been performed to determine whether haemodynamic benefits arise from the modified geometry of the Taylor anastomosis. In a conventional bypass, the distal anastomotic flow exhibited considerable spatial and temporal variations. Steep spatial gradients in the shearing force acted along the floor during systole. The effect of the Taylor geometry was to reduce gradually the momentum of the blood approaching the junction. Thus, flow disturbances were abated, undesirable flow separation at the toe was diminished, and a less adverse floor shear stress distribution prevailed in that case. Intimal thickening should be alleviated at the toe in the Taylor model where separation is reduced, and where the thrombogenic graft surface is replaced with a vein patch. Intimal hyperplasia on the floor may be inhibited in the Taylor model due to more favourable shear stresses. The improved flow through the patched anastomosis should contribute to its enhanced performance.
Authors:
J S Cole; J K Watterson; M J G O'Reilly
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Medical engineering & physics     Volume:  24     ISSN:  1350-4533     ISO Abbreviation:  Med Eng Phys     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-23     Completed Date:  2002-10-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  England    
Other Details:
Languages:  eng     Pagination:  393-401     Citation Subset:  IM    
Affiliation:
School of Aeronautical Engineering, The Queen's University of Belfast, Belfast BT9 5AG, Northern Ireland, UK. j.cole@qub.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods
Blood Vessel Prosthesis
Computer Simulation
Femoral Artery / physiopathology*,  surgery*
Hemodynamics / physiology
Models, Cardiovascular*
Polytetrafluoroethylene
Regional Blood Flow
Reproducibility of Results
Sensitivity and Specificity
Stress, Mechanical
Systole / physiology*
Veins / physiopathology*,  surgery*
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

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


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