A novel computational method allows for patient-specific estimation of arterial arm hemodynamics, which may aid in pre-operative planning for hemodialysis vascular access.
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May inform sex-specific hemodialysis access planning; leaves open whether higher female wall shear stress affects outcomes.
PURPOSE: To report the technical aspects of a novel method to generate patient-specific vascular network models of arterial vasculature for the surgical planning of vascular access (VA) for hemodialysis. METHODS: On the basis of literature data, we defined a set of rules for estimation of diameter, length and compliance of arterial network segments, at patient-specific level, as a function of general descriptors (i.e. sex, age, body size and pathology). Using this method we generated vascular network models of height hypothetical patients with different age, sex and body surface area and we computed pressures and blood flows along the arterial arm vasculature using a wave propagation model. RESULTS: Simulation results show that vascular geometry is influenced by sex, age and body size leading to important differences in hemodynamic function. Calculated wall shear stress is higher in women females as compared to men, regardless of body size and age. CONCLUSIONS: Our method facilitates estimating vascular network model parameters useful for patient-specific pre-operative assessment of blood flow distribution in the arterial arm circulation.
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Passera et al. (2012) studied this question.
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