Abstract：
:Neointimal hyperplasia (NIH) is a major obstacle to graft patency in the peripheral arteries. A complex interaction of biomechanical factors contribute to NIH development and progression, and although haemodynamic markers such as wall shear stress have been linked to the disease, these have so far been insufficient to fully capture its behaviour. Using a computational model linking computational fluid dynamics (CFD) simulations of blood flow with a biochemical model representing NIH growth mechanisms, we analyse the effect of compliance mismatch, due to the presence of surgical stitches and/or to the change in distensibility between artery and vein graft, on the haemodynamics in the lumen and, subsequently, on NIH progression. The model enabled to simulate NIH at proximal and distal anastomoses of three patient-specific end-to-side saphenous vein grafts under two compliance-mismatch configurations, and a rigid wall case for comparison, obtaining values of stenosis similar to those observed in the computed tomography (CT) scans. The maximum difference in time-averaged wall shear stress between the rigid and compliant models was 3.4 Pa, and differences in estimation of NIH progression were only observed in one patient. The impact of compliance on the haemodynamic-driven development of NIH was small in the patient-specific cases considered.
journal_name
Med Eng Physjournal_title
Medical engineering & physicsauthors
Donadoni F,Bonfanti M,Pichardo-Almarza C,Homer-Vanniasinkam S,Dardik A,Díaz-Zuccarini Vdoi
10.1016/j.medengphy.2019.09.011subject
Has Abstractpub_date
2019-12-01 00:00:00pages
137-145eissn
1350-4533issn
1873-4030pii
S1350-4533(19)30177-8journal_volume
74pub_type
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