Ninno, Federica;
Stokes, Catriona;
Aboian, Edouard;
Dardik, Alan;
Strosberg, David;
Balabani, Stavroula;
Diaz-Zuccarini, Vanessa;
(2025)
In Silico, Patient-Specific Assessment of Local Hemodynamic Predictors and Neointimal Hyperplasia Localisation in an Arteriovenous Graft.
Annals of Biomedical Engineering
, 53
(7)
pp. 1575-1589.
10.1007/s10439-025-03737-8.
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Abstract
Purpose: Most computational fluid dynamics (CFD) studies on arteriovenous grafts (AVGs) adopt idealised geometries and simplified boundary conditions (BCs), potentially resulting in misleading conclusions when attempting to predict neointimal hyperplasia (NIH) development. Moreover, they often analyse a limited range of hemodynamic indices, lack verification, and fail to link the graft-altered hemodynamics with follow-up data. This study develops a novel patient-specific CFD workflow for AVGs using pathophysiological BCs. It verifies the CFD results with patient medical data and assesses the co-localisation between CFD results and NIH regions at follow-up. // Methods: Contrast-enhanced computed tomography angiography images were used to segment the patient’s AVG geometry. A uniform Doppler ultrasound (DUS)-derived velocity profile was imposed at the inlet, and three-element Windkessel models were applied at the arterial outlets of the domain. Transient, rigid-wall simulations were performed using the k–ω SST turbulence model. The CFD-derived flow waveform was compared with the patient’s DUS image to ensure verification. Turbulent kinetic energy (TKE), helicity and near-wall hemodynamic descriptors were calculated and linked with regions presenting NIH from a 4-month follow-up fistulogram. // Results: In the analysed patient, areas presenting high TKE and balanced helical flow structures at baseline exhibit NIH growth at follow-up. Transverse wall shear stress index is a stronger predictor of NIH than other commonly analysed near-wall hemodynamic indices, since luminal areas subjected to high values greatly co-localise with observed areas of remodelling. // Conclusion: This patient-specific computational workflow for AVGs could be applied to a larger cohort to unravel the link between altered hemodynamics and NIH progression in vascular access.
| Type: | Article |
|---|---|
| Title: | In Silico, Patient-Specific Assessment of Local Hemodynamic Predictors and Neointimal Hyperplasia Localisation in an Arteriovenous Graft |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s10439-025-03737-8 |
| Publisher version: | https://doi.org/10.1007/s10439-025-03737-8 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Vascular access; Arteriovenous graft; Neointimal hyperplasia; Computational fluid dynamics; Hemodynamics |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Engineering Science Faculty Office |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10216427 |
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