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Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses: An in vitro study  Tina G. Nielsen, MD, Christian Djurhuus, Erik Morre.

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Presentation on theme: "Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses: An in vitro study  Tina G. Nielsen, MD, Christian Djurhuus, Erik Morre."— Presentation transcript:

1 Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses: An in vitro study 
Tina G. Nielsen, MD, Christian Djurhuus, Erik Morre Pedersen, MD, PhD, Jesper Laustsen, MD, J.Michael Hasenkam, MD, DMSc, Torben V. Schroeder, MD, DMSc  Journal of Vascular Surgery  Volume 24, Issue 6, Pages (December 1996) DOI: /S (96) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 In vitro flow model. Computer-controlled pulse duplicator is connected to 6 mm latex tube with adjustable central compliance and peripheral resistance. Varying degrees of stenosis can be induced 10 cm proximal to 4 mm side branch. Circulating fluid is blood analogous solution with dynamic viscosity of 4.2 cP. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

8 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

9 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

10 Fig. 2 Distal spectral Doppler waveforms. 1a, 0% stenosis without fistula, 1b, 0% stenosis with fistula, 2a, 30% stenosis without fistula, 2b, 30% stenosis with fistula, 3a, 55% stenosis without fistula, 3b, 55% stenosis with fistula, 4a, 70% stenosis without fistula, 4b, 70% stenosis with fistula. Severity of stenosis is stated as percentage diameter reduction. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

11 Fig. 3 Peak systolic velocity (PSV) related to degree of stenosis, ♢ without fistula, ○ with fistula. *p < 0.01 compared with 0% stenosis, ▵ p < 0.01 compared with series without fistula but similar degree of stenoses. Median values and ranges of six recordings. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

12 Fig. 4 Pulsatility index (PI) related to degree of stenosis, ♢ without fistula, ○ with fistula. *p < 0.01 compared with 0% stenosis, ▵ p < 0.01 compared with series without fistula but similar degree of stenoses. Median values and ranges of six recordings. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

13 Fig. 5 Pulse rise time (PRT) related to degree of stenosis, ♢ without fistula, ○ with fistula. *p < 0.01 compared with 0% stenosis, Δ p < 0.01 compared with series without fistula but similar degree of stenosis. Median values and ranges of six recordings. Journal of Vascular Surgery  , DOI: ( /S (96) ) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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