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@article{Grechy:2017:10.1063/1.5004190,
author = {Grechy, L and Iori, F and Corbett, R and Shurey, S and Gedroyc, W and Duncan, N and Caro, C and Vincent, PE},
doi = {10.1063/1.5004190},
journal = {Physics of Fluids},
title = {Suppressing unsteady flow in arterio-venous fistulae},
url = {http://dx.doi.org/10.1063/1.5004190},
volume = {29},
year = {2017}
}

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TY  - JOUR
AB  - Arterio-Venous Fistulae (AVF) are regarded as the “gold standard” method of vascular access for patients with end-stage renal disease who require haemodialysis. However, a large proportion of AVF do not mature, and hence fail, as a result of various pathologies such as Intimal Hyperplasia (IH). Unphysiological flow patterns, including high-frequency flow unsteadiness, associated with the unnatural and often complex geometries of AVF are believed to be implicated in the development of IH. In the present study, we employ a Mesh Adaptive Direct Search optimisation framework, computational fluid dynamics simulations, and a new cost function to design a novel non-planar AVF configuration that can suppress high-frequency unsteady flow. A prototype device for holding an AVF in the optimal configuration is then fabricated, and proof-of-concept is demonstrated in a porcine model. Results constitute the first use of numerical optimisation to design a device for suppressing potentially pathological high-frequency flow unsteadiness in AVF.
AU  - Grechy,L
AU  - Iori,F
AU  - Corbett,R
AU  - Shurey,S
AU  - Gedroyc,W
AU  - Duncan,N
AU  - Caro,C
AU  - Vincent,PE
DO  - 10.1063/1.5004190
PY  - 2017///
SN  - 1070-6631
TI  - Suppressing unsteady flow in arterio-venous fistulae
T2  - Physics of Fluids
UR  - http://dx.doi.org/10.1063/1.5004190
UR  - http://hdl.handle.net/10044/1/50767
VL  - 29
ER  -

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