Abstract
Background: Flow patterns inside a cuffed anastomosis are influenced by subject-specific 3D geometry. We attempted to evaluate the hemodynamic advantages of femoro-popliteal bypass using a pre-designed cuffed graft by image based computational fluid dynamics (CFD). Methods: 3D geometry was investigated by 3D digital subtraction angiography (3D DSA) and cine-angiography. Local rheological factors at the distal anastomosis were calculated by CFD analysis. The obtained data were compared to the results of calculation in a virtual model of classical end-to-side anastomosis for this case. Results: The distal anastomotic cuff eliminated the low shear stress area which would be observed at the heel of anastomosis created in a conventional end-to-side fashion. Cine-angiography of real cases suggested the beneficially changed flow pattern may enhance the clearance of blood from the anastomosis. Conclusion: Clinical CFD analysis based on 3D DSA demonstrates case-specific local flow dynamics. Image based CFD may add further information on patency estimation.
