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  4. Biomechanical, morphological and zero-stress state characterization of jugular vein remodeling in arteriovenous fistulas for hemodialysis
 
research article

Biomechanical, morphological and zero-stress state characterization of jugular vein remodeling in arteriovenous fistulas for hemodialysis

Kritharis, Eleftherios P.
•
Kakisis, John D.
•
Giagini, Athina T.
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2010
Biorheology

While the role of hemodynamic variables on the development of intimal hyperplasia in arteriovenous fistulas for hemodialysis has been examined, less is known about the intramural biomechanical factors. In this study, arteriovenous fistulas were created by implantation of e-PTFE grafts between carotid artery and jugular vein in healthy pigs. In vivo recordings exhibited a three-fold pressure and flow elevation in grafted veins after fistula creation, remaining so until sacrifice. The chief morphological observation in grafted vessels was wall thickening at two weeks, serving to restore intramural stresses to homeostatic levels, and a less marked internal diameter enlargement, gradually normalizing intimal shear after four weeks. The residual strains and opening angle, specifying the zero-stress configuration, increased with differences reaching significance at twelve weeks. Association with histomorphological findings on intima, media and adventitia growth disclosed a correlation between intimal hyperplasia and opening angle increase. Elastin and cellular contents diminished opposite to collagen content, most differences occurring within the first four weeks after grafting. Inflation/extension testing showed that post-fistula the vein wall became progressively thicker and stiffer, lacking restoration of compliance to baseline levels. The present data may further our understanding of the dynamics of venous biomechanical remodeling under pressure and flow-overload conditions.

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Type
research article
DOI
10.3233/BIR-2011-0578
Web of Science ID

WOS:000288321700003

Author(s)
Kritharis, Eleftherios P.
Kakisis, John D.
Giagini, Athina T.
Manos, Themistoklis
Stergiopulos, Nikos  
Tsangaris, Sokrates
Sokolis, Dimitrios P.
Date Issued

2010

Published in
Biorheology
Volume

47

Start page

297

End page

319

Subjects

e-PTFE distal vein anastomosis

•

histology

•

shear stress

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intramural stress

•

residual stress

•

Anastomotic Intimal Hyperplasia

•

Induced Arterial Enlargement

•

Elastic Properties

•

Mechanical-Properties

•

Hypertensive Patients

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Medial Hyperplasia

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Carotid-Artery

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Opening Angle

•

Graft Model

•

Loop Grafts

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LHTC  
Available on Infoscience
December 16, 2011
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/74765
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