3D-printed Arteriovenous Graft from Computational Fluidic Dynamics Simulation to Biomedical Device Development

抄録

Hemodialysis is an efficient treatment for kidney failure; the access is a surgically created vein used to remove and return blood during hemodialysis. There are two types of vascular access designed for long-term use, namely the arteriovenous fistula (AVF) and the arteriovenous graft (AVG). However, the AV graft, either by AVF or AVG, would also result in disturbed flow at the arteriovenous junction region which causes endothelial cell (EC) dysfunction and smooth muscle cell (SMC) hyperplasia resulting in hemodialysis vascular access dysfunction which is a major cause of morbidity and mortality in hemodialysis patients. Thus, our study aims to investigate the hemodynamic properties (i.e., disturbed flow and wall shear stress) at the arteriovenous junction region by using computational fluid dynamics (CFD) simulations, design and optimize the structure of 3D-printed AVG based on the CFD results for reducing disturbed flow resulting in pathophysiological events resulting neointimal hyperplasia and thrombosis, and ultimately vascular stenosis.