Toward longitudinal studies of hemodynamically induced vessel wall remodeling

The International Journal of Artificial Organs
Michela BozzettoAndrea Remuzzi

Abstract

Autogenous arteriovenous fistula is the preferred vascular access for hemodialysis, but it has high rates of non-maturation and early failure due to vascular stenosis. Convincing evidence supports a key role of local hemodynamics in vascular remodeling, suggesting that unsteady and disturbed flow conditions may be related to stenosis formation in arteriovenous fistula. The purpose of our study was to explore the feasibility of coupling contrast-free magnetic resonance imaging and computational fluid dynamics in longitudinal studies to identify the role of local hemodynamic changes over time in inducing vessel wall remodeling in arteriovenous fistula. We acquired contrast-free magnetic resonance imaging of arm vasculature at 1 week and 6 weeks after arteriovenous fistula creation in a 72-year-old patient. We then generated three-dimensional models and evaluated lumen cross-sectional area of arteriovenous fistula limbs. We performed high-resolution computational fluid dynamics to evaluate changes in local hemodynamics over time. Our contrast-free magnetic resonance imaging protocol provided good quality images in a short scan duration. We observed a homogeneous dilatation in the proximal artery, while there was a more pronounced ...Continue Reading

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Citations

Sep 27, 2019·The International Journal of Artificial Organs·Savino OcchionorelliEnzo Malvacini
Jul 1, 2020·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Eamonn ColleyTracie Barber

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Software Mentioned

CUBE
pimpleFoam
OpenFOAM
VMTK
ImageJ
linux
paraview
foamyHexMesh
transWSS
Vascular Modelling Toolkit ( VMTK

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