| Swirling flow pattern in a non-planar model of an interposition vein cuff anastomosis. | |
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MedLine Citation:
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PMID: 15921948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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One of the main causes of long-term failure of ePTFE grafts is the development of anastomotic intimal hyperplasia which leads to graft thrombosis. Experimental studies with bypass grafts have shown an inverse relationship between mean wall shear stress and intimal hyperplasia. The geometry of the anastomosis has a strong influence on the flow pattern and wall shear stress distribution. The aim of this in vitro study was to investigate the influence of non-planarity in a model of a distal anastomosis with interposition vein cuff, an anastomosis configuration that is increasingly being used because of improved clinical results. Laser Doppler anemometer measurements were carried out in silicone rubber models of interposition vein cuff anastomoses with planar and non-planar inflow. The pulsatile flow waveforms were typical of those found in femoro-infrapopliteal bypass. Axial and radial velocities were measured in the proximal and distal outflow segments. As expected a symmetrical helical flow pattern (Dean flow) was evident in the planar model. The model with non-planar inflow, however, gave rise to swirling flow in both the distal and proximal artery outflow segments for during the systolic phase. In patients, the anastomosis is usually non-planar. Since the configuration depends in part upon the tunnelling of the graft, this may be altered to some extent. Non-planar anastomotic configurations induce a swirling flow pattern, which may normalise wall shear stress, thereby potentially reducing intimal hyperplasia. |
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Authors:
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T V How; R K Fisher; J A Brennan; P L Harris |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Medical engineering & physics Volume: 28 ISSN: 1350-4533 ISO Abbreviation: Med Eng Phys Publication Date: 2006 Jan |
Date Detail:
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Created Date: 2006-01-23 Completed Date: 2006-04-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9422753 Medline TA: Med Eng Phys Country: England |
Other Details:
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Languages: eng Pagination: 27-35 Citation Subset: IM |
Affiliation:
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Department of Clinical Engineering, University of Liverpool, Liverpool L69 3GA, UK. thienhow@liv.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical* Computer Simulation* Coronary Artery Bypass Graft Occlusion, Vascular / pathology Hemodynamics / physiology* Humans Hyperplasia / pathology Models, Cardiovascular Stress, Mechanical Systole / physiology Veins / pathology |
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