PMID: 8945659Dec 1, 1996Paper

Geometric design improvements for femoral graft-artery junctions mitigating restenosis

Journal of Biomechanics
M LeiJ P Archie

Abstract

The present study is based on the hypothesis that nonuniform hemodynamics, represented by large time-averaged wall shear stress gradients, trigger abnormal biological processes leading to rapid restenosis, i.e. excessive tissue overgrowth and renewed plaque formation, and hence early graft failure. It implies that this problem may be significantly mitigated by finding graft-artery bypass configurations for which the wall shear stress gradient is approximately zero and hence nearly uniform hemodynamics is achieved. These fluid flow and geometric design considerations are applied to four different end-to-side anastomoses for the distal end of a femoral artery bypass with an appropriate test input pulse and a typical 20-80 flow division. A validated finite-volume code has been used to compute the transient three-dimensional velocity vector fields, wall shear stress distributions and surface contours of the wall shear stress gradients. It is shown that large anastomotic flow areas, small continuously changing bifurcation angles, and smooth junction wall curvatures reduce local time-averaged wall shear stress gradients significantly and hence should mitigate restenosis.

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Citations

Mar 18, 2005·Biomechanics and Modeling in Mechanobiology·Francesco Migliavacca, Gabriele Dubini
May 1, 2005·Journal of Biological Physics·Aike QiaoHu Zhao
Oct 31, 1998·Journal of Biomechanics·C R EthierM Ojha
Aug 1, 1997·Journal of Biomechanical Engineering·M LeiJ P Archie
Sep 17, 2008·Annals of Biomedical Engineering·Young-Ho KimAndreas Anayiotos
Jul 24, 2002·Medical Engineering & Physics·J S ColeM J G O'Reilly
Nov 25, 2003·Medical Engineering & Physics·P Worth Longest, Clement Kleinstreuer
Nov 21, 2007·Clinical Biomechanics·Aike Qiao, Youjun Liu
May 1, 2007·Medical Engineering & Physics·Jun-Mei ZhangYong Seng Tan
Jun 5, 2013·International Journal for Numerical Methods in Biomedical Engineering·J VimmrO Bublík
May 21, 2003·Journal of Vascular Surgery·Albert G HakaimW Andrew Oldenburg
Dec 19, 2003·Journal of Vascular Surgery·P Worth LongestJoseph P Archie
Jul 9, 1999·Journal of Biomechanical Engineering·J A MooreC R Ethier
Sep 17, 2004·American Journal of Physiology. Heart and Circulatory Physiology·F P GlorX Yun Xu
May 5, 2005·Annals of Biomedical Engineering·Thomas O BrienTim McGloughlin
Mar 27, 2012·Cardiovascular Engineering and Technology·Onur DurKerem Pekkan

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