NDLI: Vascular Remodeling in Autogenous Arterio-Venous Fistulas by MRI and CFD

Content Provider	Springer Nature Link
Author	Sigovan, Monica Rayz, Vitaliy Gasper, Warren Alley, Hugh F. Owens, Christopher D. Saloner, David
Copyright Year	2012
Abstract	Hemodynamic parameters play an important role in regulating vascular remodeling in arterio-venous fistula (AVF) maturation. Investigating the changes in hemodynamic parameters during AVF maturation is expected to improve our understanding of fistula failure, but very little data on actual temporal changes in human AVFs is available. The present study aimed to assess the feasibility of using a noncontrast-enhanced MRI protocol combined with CFD modeling to relate hemodynamic changes to vascular remodeling following native AVF placement. MR angiography (MRA) and MR velocimetry (MRV) data was acquired peri-operatively, 1 month, and 3 months later in three patients. Vascular geometries were obtained by segmentation of the MRA images. Pulsatile flow simulations were performed in the patient specific vascular geometries with time-dependent boundary conditions prescribed from MRV measurements. A principal result of the study is the description of WSS changes over time in the same patients. The disturbed flow observed in the venous segments resulted in a variability of the WSS distribution and could be responsible for the non-uniform remodeling of the vessel. The artery did not show regions of disturbed flow upstream from the anastomosis, which would be consistent with the uniform remodeling. MRI use demonstrated the ability to provide a comprehensive evaluation of clinically relevant information for the investigation of upper extremity AVFs. 3D geometry from MRA in combination with MRV provides the opportunity to perform detailed CFD analysis of local hemodynamics in order to determine flow descriptors affecting fistula maturation.
Starting Page	657
Ending Page	668
Page Count	12
File Format	PDF
ISSN	00906964
Journal	Annals of Biomedical Engineering
Volume Number	41
Issue Number	4
e-ISSN	15739686
Language	English
Publisher	Springer US
Publisher Date	2012-11-27
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Computational fluid dynamics Magnetic resonance imaging Vascular access Hemodialysis fistula Vascular remodeling WSS Biomedicine general Biomedical Engineering Biophysics and Biological Physics Mechanics Biochemistry
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering

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