Anatomic configuration affects the flow rate and diameter of porcine arteriovenous fistulae

Kidney International
Mahesh KrishnamoorthyPrabir Roy-Chaudhury

Abstract

Although arteriovenous fistulae are currently the preferred form of vascular access, early failure is a significant problem. Since wall shear stress is thought to play an important role in the pathogenesis of early failure, and this stress varies markedly in different fistula configurations, we assessed the influence of configuration (curved or straight) on longitudinal changes of flow rate and lumen diameter in a porcine fistula model. Fistulae were created in eight pigs between the femoral artery and vein, with each animal having a curved and a straight configuration on opposite sides. Velocity measurements were obtained by ultrasound at the time of surgery and at intermediate time points up to 28 days. Quantification of both the configuration and the internal diameter of the fistulae was determined by CT scans. The overall rate of increased flow during each time interval (0 to 2 days, 2 to 7 days, and 7 to 28 days) was more pronounced with the curved fistulae. Moreover, the luminal diameter of curved fistulae had dilated more from the time of surgery to 28 days as compared to the straight fistulae. Thus, anatomical configuration of fistulae plays a major role in flow-mediated dilatation. Identifying the optimal configuration...Continue Reading

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Citations

Apr 18, 2013·Nature Reviews. Nephrology·Miguel C Riella, Prabir Roy-Chaudhury
Aug 16, 2012·Seminars in Dialysis·Ehsan Rajabi-JagahrghRupak K Banerjee
Nov 19, 2014·BMC Nephrology·Emma AitkenDavid Kingsmore
Dec 12, 2012·Seminars in Nephrology·Prabir Roy-ChaudhuryRino Munda
Mar 31, 2012·Kidney International·Evangelos Papachristou, Roberto I Vazquez-Padron
Jul 21, 2015·Seminars in Dialysis·Marius C FlorescuMichael C Morris
Jan 3, 2013·Seminars in Dialysis·Ehsan Rajabi-JagahrghRupak K Banerjee
Apr 14, 2015·Artificial Organs·Ehsan Rajabi-Jagahrgh, Rupak K Banerjee
Aug 5, 2015·International Urology and Nephrology·Charles J DiskinAllen Lazenby
Sep 18, 2013·The Journal of Vascular Access·Prabir Roy-ChaudhuryRino Munda
Jan 20, 2018·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Ying ZhangDongmei Xu
Jul 19, 2018·American Journal of Physiology. Renal Physiology·Karl A NathZvonimir S Katusic

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