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Morphological and hemodynamical alterations in brachial artery and cephalic vein. An image‐based study for preoperative assessment for vascular access creation
Author(s) -
Aristokleous Nicolas,
Houston J. Graeme,
Browne Leonard D.,
Broderick Stephen P.,
Kokkalis Efstratios,
Gandy Stephen J.,
Walsh Michael T.
Publication year - 2018
Publication title -
international journal for numerical methods in biomedical engineering
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.741
H-Index - 63
eISSN - 2040-7947
pISSN - 2040-7939
DOI - 10.1002/cnm.3136
Subject(s) - tortuosity , hemodynamics , supine position , brachial artery , shear stress , curvature , blood flow , intimal hyperplasia , cephalic vein , medicine , cardiology , lumen (anatomy) , biomedical engineering , vein , geometry , anatomy , mathematics , blood pressure , materials science , mechanics , physics , porosity , composite material , smooth muscle
The current study aims to computationally evaluate the effect of right upper arm position on the geometric and hemodynamic characteristics of the brachial artery (BA) and cephalic vein (CV) and, furthermore, to present in detail the methodology to characterise morphological and hemodynamical healthy vessels. Ten healthy volunteers were analysed in two configurations, the supine (S) and the prone (P) position. Lumen 3D surface models were constructed from images acquired from a non‐contrast MRI sequence. Then, the models were used to numerically compute the physiological range of geometric ( n = 10) and hemodynamic ( n = 3) parameters in the BA and CV. Geometric parameters such as curvature and tortuosity, and hemodynamic parameters based on wall shear stress (WSS) metrics were calculated with the use of computational fluid dynamics. Our results highlight that changes in arm position had a greater impact on WSS metrics of the BA by altering the mean and maximum blood flow rate of the vessel. Whereas, curvature and tortuosity were found not to be significantly different between positions. Inter‐variability was associated with antegrade and retrograde flow in BA, and antegrade flow in CV. Shear stress was low and oscillatory shear forces were negligible. This data suggests that deviations from this state may contribute to the risk of accelerated intimal hyperplasia of the vein in arteriovenous fistulas. Therefore, preoperative conditions coupled with post‐operative longitudinal data will aid the identification of such relationships.