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Title:: Numerical simulation analysis of autogenous arteriovenous fistula with end-to-side anastomosis and side-to-side anastomosis

作者:: 张嘉惠1; 齐天成2; 张怀新2△; （1.上海交通大学医学院附属仁济医院，上海交通大学医学院临床研究中心，上海 200127；2.上海交通大学船舶海洋与建筑工程学院，上海交通大学海洋工程国家重点实验室，上海 200240）

Author(s):: ZHANG Jiahui1; QI Tiancheng2; ZHANG Huaixin2; （1.Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University School of Medicine Clinical Research Center, Shanghai 200127, China;2.School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240）

Keywords:: Arteriovenous fistulas; Computational fluid dynamics; End-to-side anastomosis; Side-to-side anastomosis

摘要:: 为分析动静脉内瘘狭窄的血流动力学特性，本研究基于计算机辅助技术，分别建立了端侧吻合和侧侧吻合下的动静脉内瘘模型，并通过计算流体力学分析软件，对不同时刻下的血流动力学特性进行分析。结果表明，两种内瘘模型血流特性最差的部位均在瘘口近心端，特别是在静脉内壁上，低速区域和低壁面切应力区域出现集中现象。端侧动静脉内瘘相较于侧侧动静脉内瘘，在瘘口附近发生涡流的现象有所缓和，但在收缩期存在较高的壁面切应力，且高震荡切应力指数的面积更大，可能引发动静脉内瘘病变与失功。本研究的计算流体力学分析结果，可为设计和选择动静脉内瘘的吻合方案提供参考。

Abstract:: In order to analyze the hemodynamic characteristics of stenosis in the arteriovenous fistula. Based on computer-aided technology, the arteriovenous fistula models under end-to-side anastomosis and side-to-side anastomosis were established and the hemodynamic characteristics at different moments were analyzed by computational fluid dynamics analysis software. The results showed that the worst hemodynamic characteristics of two fistula models were at the proximal end of the fistula, especially on the inner wall of the vein, the low-velocity region and low wall shear stress region were concentrated. Compared to the side-to-side arteriovenous fistula, the vortex occurring near the fistula was reduced in the end-to-side arteriovenous fistula, but excessive wall shear stress was present during systole,and the area of high oscillatory shear stress index was larger. This may cause arteriovenous fistula lesions and loss of work. The results of the computational fluid dynamics analysis can provide a reference for the design and selection of the anastomosis scheme of the arteriovenous fistula.