Substitution-rate based screening model to assess stenosis progression in experimental stenotic arteriovenous grafts
| Autor: | Yi Chen Mai, Ming Jui Wu, Chung Dann Kan, Chia-Hung Lin, Wei Ling Chen |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Arteriovenous Anastomosis medicine.medical_treatment 0206 medical engineering Biomedical Engineering Biophysics Hemodynamics Health Informatics Bioengineering Blood Pressure 02 engineering and technology Inflow Constriction Pathologic 030204 cardiovascular system & hematology Biomaterials 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Internal medicine medicine Humans Aged Aged 80 and over business.industry Middle Aged medicine.disease 020601 biomedical engineering Thrombosis Stenosis Blood pressure Cardiology Outflow Female Hemodialysis business Blood Flow Velocity Information Systems |
| Zdroj: | Technology and health care : official journal of the European Society for Engineering and Medicine. 25(5) |
| ISSN: | 1878-7401 |
| Popis: | An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model. In our practical measurements, we found that inflow and outflow channeled through a narrowed access indicated both pressure and resistance differences as the degree of stenosis (DOS) gradually increased. A substitution-rate matrix was conducted to replace bilateral pressure variations, while a transition probability matrix was calculated. Differences in transition probabilities were then used to distinguish between normal conditions and flow instabilities using the distance estimation method. The joint probability decayed from0.81 to 0.00 could be specified to identify the progression in stenosis levels from a DOS% = 50.0-95.0%. Average joint probabilities were found to be inversely related with the DOS using a non-linear regression (R2 0.90). Hence, the joint probability could be specified as a critical threshold,0.81, to identify the severity stenosis level, DOS% ⩾ 70%, in the assessment of coexisting inflow and outflow stenoses. Experimental results suggest that the proposed model is superior to hemodynamic analysis and traditional intelligent method, and can be used for dysfunction screening during HD treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|