TITLE:
A Computational Analysis of the Influence of Anastomosis Angle on Stenosis-Prone Locations during Radio-Cephalic Arteriovenous Fistula Maturation
AUTHORS:
Yang Yang, Pascale Kulisa, Benyebka Bou-Saïd, Mahmoud El Hajem, Serge Simoens, Nellie Della Schiava
KEYWORDS:
Radio-Cephalic Arteriovenous Fistula (RCAVF), Anastomosis Angle, Maturation, Wall Shear Stress Distribution, Stenosis-Prone Locations
JOURNAL NAME:
Journal of Biomedical Science and Engineering,
Vol.16 No.6,
July
28,
2023
ABSTRACT: In dialysis treatment, the radio-cephalic arteriovenous fistula (RCAVF) is a commonly used fistula, yet its low maturation rate remains a challenge. To enhance surgical outcomes, the relationship between stenosis-prone locations and RCAVF anastomosis angle is studied during maturation by developing two sets of RCAVF models for early (non-mature) and mature RCAVFs at five anastomosis angles. The impact of hemodynamics and wall shear stress (WSS) is examined to determine optimal anastomotic angles. Results indicate that acute angles produce more physiological WSS distributions and fewer disturbed regions, with early stenosis-prone regions located near the anastomosis that shift to the bending venous segment during remodeling. A pilot study comparing clinical and numerical results is conducted for validation.