1. Optimization of Maturation of Radio-Cephalic Arteriovenous Fistula Using a Model Relating Energy Loss Rate and Vascular Geometric Parameters
- Author
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Benyebka Bou-Saïd, Serge Simoëns, Pascale Kulisa, Yang Yang, Patrick Lermusiaux, Nellie Della Schiava, Mahmoud El Hajem, Laboratoire de Mécanique des Contacts et des Structures [Villeurbanne] (LaMCoS), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Mecanique des Fluides et d'Acoustique (LMFA), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Cephalic vein ,medicine.medical_specialty ,Critical energy loss rate (CEL) ,Fistula ,Arteriovenous fistula ,Vessel geometric parameters ,Blood flow ,Anastomosis ,medicine.disease ,[SPI]Engineering Sciences [physics] ,medicine.anatomical_structure ,Numerical simulation and modelling ,Hemodialysis ,Internal medicine ,medicine.artery ,medicine ,Cardiology ,Vascular resistance ,Maturity ,Radial artery ,Radio-cephalic arteriovenous fistula (RCAVF) ,ComputingMilieux_MISCELLANEOUS ,Mathematics ,Artery - Abstract
International audience; The main reason for the early failure of radio-cephalic arteriovenous fistula (RCAVF) is non-maturity, which means that the blood flow rate in the fistula cannot increase to the expected value for dialysis. From a mechanical perspective, the vascular resistance at the artificially designed anastomosis causes an energy loss that affects blood flow rate growth and leads to early failure. This research studied how to maximize the RCA VF maturity and primary patency by controlling the energy loss rate. We theoretically analyzed and derived a model that evaluates the energy loss rate Eavf in RCAVF as a function of its blood vessel geometric parameters (GPs) for given flow rates. There was an aggregate of five controllable GPs in RCAVF: radial artery diameter (Dra), cephalic vein diameter (Dcv), blood vessel distance between artery and vein (h), anastomotic diameter (Da), and anastomotic angle (). Through this analysis, it was found that Eavf was inversely proportional to Dra, Dcv, Da, and , whereas proportional to h. Therefore, we recommended surgeons choose the vessels with large diameters , close distance, and increase the diameter and angle of the anastomosis to decrease the early failure of RCAVF. Simultaneously, we could explain the results of many clinical empiricisms with our formula. We found that increasing Dcv and were more significant in reducing Eavf than increasing Dra and Da. Based on our model, we could define two critical energy loss rates (CELa, CELb) to help surgeons evaluate the blood vessels and choose the ideal range of . Help them design the preoperative RCAVF plan for each patient to increase the maturity and the primary patency of RCAVF.
- Published
- 2021
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