Key result
The 45 degrees backward anastomosis model demonstrated a smaller low-recirculation-flow region, higher time-averaged wall shear stress, and more favorable shear stress patterns compared to other models.
Why the study?
Does the anastomotic angle affect flow and haemodynamic parameter distribution patterns in proximal anastomosis models?
Does the anastomotic angle affect flow and haemodynamic parameter distribution patterns in proximal anastomosis models?
A 45-degree backward anastomotic angle optimizes hemodynamic parameters in proximal anastomosis models, which may help mitigate the development of intimal hyperplasia.
Hypothesis-generating for optimal proximal anastomosis angle; human trials needed before any practice change.
This study was designed to examine the effects of the anastomotic angle on the flow and haemodynamic parameter distribution patterns of the proximal anastomoses, with emphasis on identifying site-specific haemodynamic features that could reasonably be expected to trigger the initiation and further development of anastomotic intimal hyperplasia. Particle image velocimetry measurements were carried out with three simplified glass proximal models under a physiological flow condition. The results revealed that the disturbed flow and the induced shear stress patterns including low recirculation flow, stagnation point, high wall shear stress, high temporal wall shear stress gradient, low time-averaged wall shear stress (TAWSS), and high oscillating shear index (OSI) occurred around the anastomotic joints and the flow field at proximal anastomosis was strongly affected by the anastomotic angle. Among the three models investigated, the 45 degrees backward anastomosis is found to have a smaller low-recirculation-flow region along the graft inner wall, non-stationary stagnation, and separation points, a higher TAWSS and smaller high-OSI low-TAWSS and low-OSI high-TAWSS regions.
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Chua et al. (2008) studied Anastomotic intimal hyperplasia. Anastomotic angle (45 degrees backward anastomosis) vs. Other anastomotic angles was evaluated on Flow and haemodynamic parameter distribution patterns (shear stress, recirculation flow, stagnation point, TAWSS, OSI). The 45 degrees backward anastomosis model demonstrated a smaller low-recirculation-flow region, higher time-averaged wall shear stress, and more favorable shear stress patterns compared to other models.
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