Disturbed flow in a patient-specific arteriovenous fistula for hemodialysis: Multidirectional and reciprocating near-wall flow patterns Bogdan Ene-Iordache,

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Disturbed flow in a patient-specific arteriovenous fistula for hemodialysis: Multidirectional and reciprocating near-wall flow patterns Bogdan Ene-Iordache, Cristina Semperboni, Gabriele Dubini, Andrea Remuzzi Journal of Biomechanics Volume 48, Issue 10, Pages 2195-2200 (July 2015) DOI: 10.1016/j.jbiomech.2015.04.013 Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 1 (a) Patient-specific blood volumetric flow rate waveforms derived from US pulsed-Doppler velocity spectra images. Continuous and dashed curves represent the blood flow in the PA and DA, respectively. Blood flow in the DA changes direction during the cardiac cycle, negative is antegrade (towards the hand) and positive is retrograde flow. Horizontal lines indicate the time-averaged blood flow rate over the cardiac cycle, 844mL/min for PA and 86.5mL/min for DA, respectively. (b) 3-D surface of the model and detail of the surface and volume meshwork showing internal cells and the boundary layers near the wall. PA, proximal artery; DA, distal artery. Arrows indicate the main direction of blood flow. Journal of Biomechanics 2015 48, 2195-2200DOI: (10.1016/j.jbiomech.2015.04.013) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 2 Distribution of hemodynamic wall parameters on the AVF wall: (a) plot of OSI; (b) plot of tranWSS. Values of OSI between 0 and 0.1 and of transWSS below 10dyne/cm2 were represented in light grey to emphasize the pattern of disturbed flow on the AVF surface. Left, front view; right, rear view of the AVF. Journal of Biomechanics 2015 48, 2195-2200DOI: (10.1016/j.jbiomech.2015.04.013) Copyright © 2015 Elsevier Ltd Terms and Conditions

Fig. 3 Plot of WSS vector magnitude variation throughout the cardiac cycle for four feature points on the AVF surface. The sign of the WSS vector was taken into account by considering positive the direction of the bulk flow. Position of feature points (P1–P4) on the AVF surface is as depicted in Fig. 2a right. The characteristics of near-wall disturbed flow adjacent to these points are summarized in Table 2. Continuous line, WSS magnitude; dashed line, time-averaged WSS over the pulse cycle. Journal of Biomechanics 2015 48, 2195-2200DOI: (10.1016/j.jbiomech.2015.04.013) Copyright © 2015 Elsevier Ltd Terms and Conditions