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Research Papers

Computational Model of the Arterial and Venous Needle During Hemodialysis

[+] Author and Article Information
David Fulker

School of Mechanical and
Manufacturing Engineering,
University of New South Wales,
Kensington Campus,
Kensington, NSW 2025, Australia
e-mail: d.fulker@unsw.edu.au

Anne Simmons

School of Mechanical and
Manufacturing Engineering,
University of New South Wales,
Kensington Campus,
Kensington, NSW 2025, Australia
e-mail: a.simmons@unsw.edu.au

Tracie Barber

School of Mechanical and
Manufacturing Engineering,
University of New South Wales,
Kensington Campus,
Kensington, NSW 2025, Australia
e-mail: t.barber@unsw.edu.au

Manuscript received June 5, 2016; final manuscript received August 1, 2016; published online November 4, 2016. Assoc. Editor: Tim David.

J Biomech Eng 139(1), 011005 (Nov 04, 2016) (7 pages) Paper No: BIO-16-1238; doi: 10.1115/1.4034429 History: Received June 05, 2016; Revised August 01, 2016

Arteriovenous fistulae (AVF) are the favored choice of vascular access but still have poor long-term success. Hemodynamic parameters play an important role in vascular health and have been linked to the development of intimal hyperplasia (IH), a pathological growth of the blood vessel initiated by injury. This study aimed to investigate the hemodynamics surrounding the arterial needle (AN) and venous needle (VN), using computational fluid dynamics. A range of blood flow rates, needle positions, and needle orientations were examined. Disturbed flows were found around AN tip in both antegrade and retrograde orientations, which result in regions of high residency time on the surface of the vein and may disrupt endothelial function. Conversely, a high speed jet exits the VN, which produced high wall shear stresses (WSSs) at the point of impingement which can damage the endothelium. The secondary flows produced by jet dissipation also resulted in regions of high residency time, which may influence endothelial structure, leading to IH. The use of shallow needle angles, a blood flow rate of approximately 300 ml/min, and placement of the needle tip away from the walls of the vein mitigates this risk.

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Figures

Grahic Jump Location
Fig. 1

Pathlines and velocity contours on cross-sectional planes for the arterial needle in an antegrade orientation during diastole. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 2

Relative residency time on the wall of the vein normalized by the mean wall shear stress for the arterial needle in the antegrade orientation. Low levels of high RRT (<10) have been highlighted to emphasize regions of strong secondary flows. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 3

Pathlines and velocity contours on cross-sectional planes for the arterial needle in a retrograde orientation during diastole. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 4

Relative residency time on the wall of the vein normalized by the mean wall shear stress for the arterial needle in the retrograde orientation. Low levels of high RRT (<10) have been highlighted to emphasize regions of strong secondary flows. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 5

Velocity isosurfaces (1 m/s) visualizing the venous needle jet. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 6

Time average wall shear stress on the wall of the vein for the venous needle. Values < 10 Pa have been highlighted to emphasize regions of excessively high stress. The scale has also been capped at the threshold reported to cause endothelial damage (40 Pa). (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

Grahic Jump Location
Fig. 7

Relative residency time on the wall of the vein normalized by the mean wall shear stress for the arterial needle in the retrograde orientation. Low levels of high RRT (<10) have been highlighted to emphasize regions of strong secondary flows. (a)–(c) Variation in blood flow rate (200 ml/min, 300 ml/min, 400 ml/min). (d)–(f) Variation in needle angle (10 deg, 20 deg, 30 deg). (g)–(i) Variation in needle position (bottom, central, top).

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