Numerical investigation of the haemodynamics at a patched arterial bypass anastomosis

被引:62
作者
Cole, JS [1 ]
Watterson, JK
O'Reilly, MJG
机构
[1] Queens Univ Belfast, Sch Aeronaut Engn, Belfast BT9 5AG, Antrim, North Ireland
[2] Belfast City Hosp, Vasc Surg Unit, Belfast BT9 7AB, Antrim, North Ireland
关键词
biofluid mechanics; bypass graft anastomosis; Taylor patch; haemodynamics; intimal hyperplasia; numerical;
D O I
10.1016/S1350-4533(02)00038-3
中图分类号
R318 [生物医学工程];
学科分类号
0831 [生物医学工程];
摘要
Intimal hyperplasia at arterial bypass graft anastomoses is a major factor responsible for graft failure. A revised surgical technique, incorporating a Taylor vein patch into the distal anastomosis of PTFE grafts, results in a decrease in intimal hyperplasia and improved patency rates. Numerical simulations of pulsatile, non-Newtonian blood flow through life-like femorodistal bypass models have been performed to determine whether haemodynamic benefits arise from the modified geometry of the Taylor anastomosis. In a conventional bypass, the distal anastomotic flow exhibited considerable spatial and temporal variations. Steep spatial gradients in the shearing force acted along the floor during systole. The effect of the Taylor geometry was to reduce gradually the momentum of the blood approaching the junction. Thus, flow disturbances were abated, undesirable flow separation at the toe was diminished, and a less adverse floor shear stress distribution prevailed in that case. Intimal thickening should be alleviated at the toe in the Taylor model where separation is reduced, and where the thrombogenic graft surface is replaced with a vein patch. Intimal hyperplasia on the floor may be inhibited in the Taylor model due to more favourable shear stresses. The improved flow through the patched anastomosis should contribute to its enhanced performance. (C) IPEM Published by Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:393 / 401
页数:9
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