Hemodynamic Analysis of a Microanastomosis Using Computational Fluid Dynamics

Abstract

Background Technical issues in free flap transfer, such as the selection of recipient vessels and the positioning and method of anastomosis of the vascular pedicle, have been the subject of vigorous debate. Recent developments in computational fluid dynamics (CFD) have enabled the analysis of blood flow within microvessels. In this study, CFD was used to analyze hemodynamics in a microanastomosis. Methods In the fluid calculation process, the fluid domain modelizes microvessels with anastomosis. The inlet flow conditions were measured as venous waveform, and the fluid is simulated as blood. Streamlines (SL), wall shear stress (WSS), and oscillatory shear index (OSI) at the anastomosis were visualized and analyzed for observing effects from the flow field. Results Some flow disruption was evident as the SL passed over the sutures. The maximum recorded WSS was 13.37 Pa where the peak of a suture was exposed in the lumen. The local maximum value of the OSI was 0.182, recorded at the base of the anastomosis on the outflow side. Conclusion In the ideal anastomosis, the SL is disrupted as little as possible by the sutures. The WSS indicated that thrombus formation is unlikely to occur at suture peaks, but more likely to occur at the base of sutures, where the OSI is high. Tight suture knots are important in microanastomosis.

Analysis of the Optimum Tapering Angle in Microanastomosis Using Computational Fluid Dynamics

“…The use of blood flow analysis by CFD to assess the risk of cerebral aneurysm rupture has been widely reported. [10][11][12] Other studies have described the value of CFD for microvascular anastomoses, 4,5,13 but the present study is the first to focus on investigating the optimum tapering angle.…”

Sutureless vascular anastomotic approaches and their potential impacts

“…Concurrent advancements in tissue adhesives are likely to complement these developments, tailoring solutions to diverse surgical requirements. The advent of technologies like 3D printing could enable custom device designs based on individual vascular anatomy, while breakthroughs in computational modeling are expected to facilitate the optimization of new devices by predicting their behavior before physical creation [ [164] , [165] , [166] , [167] , [168] ]. These developments signal a promising future for sutureless microvascular anastomotic techniques, potentially revolutionizing plastic and reconstructive surgery in the years ahead.…”

Reconstruction for Bilateral Internal Jugular Vein Perfusion Disruption

“…Since there is usually a difference in caliber between the IJV and EJV systems, it is necessary to adjust the caliber using techniques such as tapering [12][13][14] when performing end-to-end anastomosis, although this is not necessary for end-to-side anastomosis. By cutting the stump of the IJV obliquely, it is possible to restore smooth blood flow and avoid the risk of anastomotic thrombosis without consideration of the difference in vessel diameter.…”