Wall Shear Stress Measurement Using Phase Contrast Magnetic Resonance Imaging with Phase Contrast Magnetic Resonance Angiography in Arteriovenous Polytetrafluoroethylene Grafts

Misra, Sanjay; Fu, Alex A.; Misra, Khamal D.; Glockner, James F.; Mukhopadhyay, Debabrata

doi:10.1177/0003319709335908

Cited by 14 publications

(15 citation statements)

References 30 publications

(66 reference statements)

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“…Two studies used contrast-enhanced MR angiography and 2D PC-MRV to investigate temporal changes in the geometry, flow, and WSS in pigs following placement of PTFE grafts. 26,27 Krishnamoorthy et al 17 applied CFD to simulate complete WSS profiles in two configurations of native AVFs created in pigs. They found an inverse correlation between mean WSS at the time of AVF placement and the degree of luminal stenosis at 42 days post-surgery.…”

Section: Discussionmentioning

confidence: 99%

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Vascular Remodeling in Autogenous Arterio-Venous Fistulas by MRI and CFD

et al. 2012

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Hemodynamic parameters play an important role in regulating vascular remodeling in arterio-venous fistula (AVF) maturation. Investigating the changes in hemodynamic parameters during AVF maturation is expected to improve our understanding of fistula failure, but very little data on actual temporal changes in human AVFs is available. The present study aimed to assess the feasibility of using a noncontrast-enhanced MRI protocol combined with CFD modeling to relate hemodynamic changes to vascular remodeling following native AVF placement. MR angiography (MRA) and MR velocimetry (MRV) data was acquired peri-operatively, 1 month, and 3 months later in three patients. Vascular geometries were obtained by segmentation of the MRA images. Pulsatile flow simulations were performed in the patient specific vascular geometries with time-dependent boundary conditions prescribed from MRV measurements. A principal result of the study is the description of WSS changes over time in the same patients. The disturbed flow observed in the venous segments resulted in a variability of the WSS distribution and could be responsible for the non-uniform remodeling of the vessel. The artery did not show regions of disturbed flow upstream from the anastomosis, which would be consistent with the uniform remodeling. MRI use demonstrated the ability to provide a comprehensive evaluation of clinically relevant information for the investigation of upper extremity AVFs. 3D geometry from MRA in combination with MRV provides the opportunity to perform detailed CFD analysis of local hemodynamics in order to determine flow descriptors affecting fistula maturation.

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Section: Discussionmentioning

confidence: 99%

“…26,27 However, very little data describing the changes in humans is available. Description of changes in estimated WSS and vessel diameter at specific locations was obtained by US studies, 5 but no 3D analysis was provided.…”

Section: Introductionmentioning

confidence: 99%

Vascular Remodeling in Autogenous Arterio-Venous Fistulas by MRI and CFD

et al. 2012

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“…It has been shown that there is an increase in mRNA of ADAMTS-1 from human umbilical vein endothelial cells (HUVEC) and cardiac microvascular endothelial cells which have been exposed to shear stress [30]. Increased shear stress has been hypothesized as a potential etiology for hemodialysis graft failure [7, 31, 32]. In the present study, we observed significant increase in gene expression of ADAMTS-1 at the venous stenosis when compared to control vein by day 7.…”

Section: Discussionmentioning

confidence: 99%

Increased Expression of HIF-1α, VEGF-A and Its Receptors, MMP-2, TIMP-1, and ADAMTS-1 at the Venous Stenosis of Arteriovenous Fistula in a Mouse Model with Renal Insufficiency

Misra

Shergill

Yang

et al. 2010

Journal of Vascular and Interventional Radiology

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115

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Purpose-A mouse model of renal insufficiency with arteriovenous fistula (AVF) and venous stenosis was created. We tested the hypothesis that there is increased gene expression of hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor-A (VEGF-A) and its receptors (VEGFR-1, -2), matrix metalloproteinase-2 (MMP-2), -9 (MMP-9), tissue inhibitor of metalloproteinase-1, -2 (TIMP-1, -2), and a disintegrin and metalloproteinase thrombospondin-1 (ADAMTS-1) at the venous stenosis.Materials and methods-Nineteen male C57BL/6 mice underwent a left nephrectomy and a surgical occlusion of the right upper pole to induce renal insufficiency and characterized in eight mice. Twenty eight days later, an AVF (n=11) was created from the right carotid artery to ipsilateral jugular vein and the mice were sacrificed at day 7 (n=4) and day 14 (n=4). The outflow and control veins were removed for gene expression. Three mice were sacrificed at day 28 for histologic analysis.

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“…The high flow momentum entering the vein at an unfavorable angle is thought to be one of the major causes for IH of the vein. 16,17 The Venaflo prosthesis was developed to decrease the high wall shear forces. 8 This graft uses a venous anastomotic cuff that effectively reduces the shear forces present near the venous wall.…”

Section: Discussionmentioning

confidence: 99%