Experimental evaluation of a patient specific Brachio-Cephalic Arterio Venous Fistula (AVF): Velocity flow conditions under steady and pulsatile waveforms

Computational modeling of the cephalic arch with jugulocephalic vein variant predicts hemodynamic profiles in patients with brachiocephalic fistula

“…Because of complexity of hemodynamic environment in brachiocephalic fistula, computational modeling is widely used for hemodynamic study of brachiocephalic fistula [1]. In intravital cases, these hemodynamic studies often use ultrasound or CT for hemodynamic simulating.…”

“…This computational model underpins the concept that a regular management of hemodynamic profiles in patients with jugulocephalic vein variant after brachiocephalic fistula may help stabilize or modulate fluid dynamics in this specific situation. iameter at the end of the segment superior to clavicle 0.51 1 Angle between straight segment and vertical axis: The straight segment inclined to right side was defined as negative number (-8°). 2 Anteversion angle of straight segment: The angle of straight segment anterior to vertical axis.…”

“…2 Angle between transverse cervical vein and vertical axis: The transverse cervical vein inclined to left side was defined as negative number (-74°). the joining point 1 Angle between straight segment and vertical axis: The straight segment inclined to right side was defined as negative number (-7°). 2 Angle between oblique segment and vertical axis: The oblique segment inclined to left side was defined as positive number (30°).…”

“…We raised several concerning scientific questions based on this specific "Tjunction" single-conduit supraclavicular cephalic arch draining into the external jugular vein underwent brachiocephalic fistula: (1) the features of the hemodynamic abnormalities during maturation; (2) the theoretical reasons of stenosis and maturation failure; (3) the existence of the risk after stenosis. This study will propose new theoretical explanations for the above-mentioned questions by means of 3D computational hemodynamic modeling, provide reference for clinical practice, and point out the research direction for further in-depth study on the mechanism of hemodynamic changes and the deep-seated causes of the stenosis in this specific "Tjunction" single-conduit supraclavicular cephalic arch draining into the external jugular vein.…”