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research-article

Assessing the disturbed flow and the transition to turbulence in the arteriovenous fistula

[+] Author and Article Information
Simone Stella

EOC-Ente Ospedaliero Cantonale, Lugano, Switzerland and MOX, Dipartimento di Matematica, Politecnico di Milano, Italy
simone.stella@polimi.it

Christian Vergara

LABS, Dipartimento di Chimica, Materiali e Ingegneria Chimica “Giulio Natta” Politecnico di Milano, Italy
christian.vergara@polimi.it

Luca Giovannacci

EOC-Ente Ospedaliero Cantonale, Lugano, Switzerland
luca.giovannacci@eoc.ch

Alfio Quarteroni

MOX, Dipartimento di Matematica, Politecnico di Milano, Italy
alfio.quarteroni@polimi.it

Giorgio Prouse

EOC-Ente Ospedaliero Cantonale, Lugano, Switzerland
giorgio.prouse@eoc.ch

1Corresponding author.

ASME doi:10.1115/1.4043448 History: Received October 28, 2018; Revised April 03, 2019

Abstract

The arteriovenous fistula (AVF) is the main form of vascular access for hemodialysis patients, but its maintenance is very challenging. Its failure is mainly related to intimal hyperplasia, leading to stenosis. The aim of this work is twofold: i) to perform a computational study for the comparison of the disturbed blood dynamics in different configurations of AVF and ii) to assess the amount of turbulence developed by the specific geometric configuration of AVF. To this aim, we reconstructed realistic 3D geometries of two patients with a side-to-end AVF, performing a parametric study by changing the angle of incidence at the anastomosis. We solved the incompressible Navier-Stokes equations modeling the blood as an incompressible and Newtonian fluid. Large Eddy Simulations (LES) were considered to capture the transition to turbulence developed at the anastomosis. The values of prescribed boundary conditions are obtained from clinical Echo-Color Doppler measurements. To assess the disturbed flow, we considered hemodynamic quantities such as the velocity field, the pressure distribution, and wall shear stresses derived quantities, whereas to quantify the transition to turbulence, we computed the standard deviation of the velocity field among different heartbeates and the turbulent kinetic energy.

Copyright (c) 2019 by ASME
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