Computational study on the haemodynamic and mechanical performance of electrospun polyurethane dialysis grafts

Sjeng Quicken, Yeshi de Bruin, Barend Mees, Jan Tordoir, Tammo Delhaas, Wouter Huberts (Corresponding author)

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Compliance mismatch between an arteriovenous dialysis graft (AVG) and the connected vein is believed to result in disturbed haemodynamics around the graft–vein anastomosis and increased mechanical loading of the vein. Both phenomena are associated with neointimal hyperplasia development, which is the main reason for AVG patency loss. In this study, we use a patient-specific fluid structure interaction AVG model to assess whether AVG haemodynamics and mechanical loading can be optimised by using novel electrospun polyurethane (ePU) grafts, since their compliance can be better tuned to match that of the native veins, compared to gold standard, expanded polytetrafluoroethylene (ePTFE) grafts. It was observed that the magnitude of flow disturbances in the vein and the size of anastomotic areas exposed to highly oscillatory shear (OSI > 0.25) and very high wall shear stress (>40Pa) were largest for the ePTFE graft. Median strain and von Mises stress in the vein were similar for both graft types, whereas highest stress and strain were observed in the anastomosis of the ePU graft. Since haemodynamics were most favourable for the ePU graft simulation, AVG longevity might be improved by the use of ePU grafts.

Original languageEnglish
Pages (from-to)713-722
Number of pages10
JournalBiomechanics and Modeling in Mechanobiology
Volume19
Issue number2
Early online date2 Nov 2019
DOIs
Publication statusPublished - Apr 2020

Keywords

  • Dialysis graft
  • Fluid structure interaction modelling
  • Material choice
  • Polyurethane

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