A pulse wave propagation model to support decision-making in vascular access planning in the clinic
| Autor: | Emh Mariëlle Bosboom, Wilco Kroon, Jhm Jan Tordoir, van de Fn Frans Vosse, Wouter Huberts, A.S. Bode, RN Planken |
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| Přispěvatelé: | Biomedische Technologie, RS: CARIM - R2.09 - Cardiovascular system dynamics, MUMC+: MA AIOS Heelkunde (9), Surgery, RS: CARIM School for Cardiovascular Diseases, ACS - Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Cardiovascular Biomechanics |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Arteriovenous Anastomosis
Wave propagation Computer science Decision Making Biomedical Engineering Biophysics Vascular access Lumped parameter model Arteriovenous fistula Models Biological Veins Womersley number Pulse wave propagation Renal Dialysis medicine Humans Postoperative Period Simulation Patient-specific modeling Pulse wave propagation model Electrical analog Arteries medicine.disease Flow (mathematics) Hemodialysis Blood Circulation Preoperative Period |
| Zdroj: | Medical Engineering & Physics, 34(2), 233-248. ELSEVIER SCI LTD Medical engineering & physics, 34(2), 233-248. Elsevier BV Medical Engineering & Physics, 34(2), 233-248. Elsevier |
| ISSN: | 1350-4533 |
| Popis: | The preferred vascular access for hemodialysis is an autologous arteriovenous fistula (AVF) in the arm: a surgically created connection between an artery and vein. The surgeon selects the AVF location based on experience and preoperative diagnostics. However, 20-50% of all lower arm AVFs are hampered by a too low access flow, whereas complications associated with too high flows are observed in 20% of all upper arm AVFs. We hypothesize that a pulse wave propagation model fed by patient-specific data has the ability to assist the surgeon in selecting the optimal AVF configuration by predicting direct postoperative flow. Previously, a 1D wave propagation model (spectral elements) was developed in which an approximated velocity profile was assumed based on boundary layer theory. In this study, we derived a distributed lumped parameter implementation of the pulse wave propagation model. The elements of the electrical analog for a segment are based on the approximated velocity profiles and dependent on the Womersley number. We present the application of the lumped parameter pulse wave propagation model to vascular access surgery and show how a patient-specific model is able to predict the hemodynamical impact of AVF creation and might assist in vascular access planning. The lumped parameter pulse wave propagation model was able to select the same AVF configuration as an experienced surgeon in nine out of ten patients. In addition, in six out of ten patients predicted postoperative flows were in the same order of magnitude as measured postoperative flows. Future research should quantify uncertainty in model predictions and measurements. (C) 2011 IPEM. Published by Elsevier Ltd. All rights reserved |
| Databáze: | OpenAIRE |
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