Applicability of an entry flow model of the brachial artery for flow models of the hemodialysis fistula

Sulav Bastola, William D Paulson, Steven A. Jones

Research output: Contribution to journalArticle

Abstract

The native arteriovenous fistula creates a shunt that provides the high blood flow that is needed for dialysis. Lumped parameter hemodynamic models of the arteriovenous fistula can be used to predict shear stresses and pressure losses and can be applied to help understand unsolved problems such as the high rate of arteriovenous fistula maturation failure. These models combine together flow components, such as arteries, stenosis, anastomoses, arterial compliance, and blood inertia, and each component must be modeled with an appropriate pressure-flow relationship. Poiseuille flow is generally assumed for straight vessels, but the unique high flow rates within the brachial artery of an arteriovenous fistula are expected to induce entry flow effects that are neglected in this model. To estimate the importance of these effects, brachial artery flow was modeled in a low-resistance network, such as the one that occurs when an arteriovenous fistula is constructed, through the lumped parameter model, and the predicted flow rates and pressures were compared to those predicted by computational fluid dynamics. When Poiseuille flow was assumed, the flow rate from the lumped parameter model was consistently larger than that from computational fluid dynamics, with a cycle-averaged error of 36.8%. When an entry flow model (Shah) was assumed, the lumped parameter-based flow was 6% lower than the computational fluid dynamics model at the peak of the flow waveform, and the cycle-averaged error was reduced to 7.8%. Thus, in a low-resistance (high flow) arteriovenous fistula circuit, an entry flow model can account for steeper near-wall velocity gradients. This result can provide a useful guide for designing engineering models of the arteriovenous fistula.

Original languageEnglish (US)
Pages (from-to)766-773
Number of pages8
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Volume231
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

    Fingerprint

Keywords

  • Arteriovenous fistula
  • computational fluid dynamics
  • hemodynamics modeling
  • impedance: hemodynamics
  • mathematical modeling (medical)
  • vascular access
  • waveforms: hemodynamics

ASJC Scopus subject areas

  • Mechanical Engineering

Cite this