Imperial College London

Professor Peter Vincent

Faculty of EngineeringDepartment of Aeronautics

Professor of Computational Fluid Dynamics
 
 
 
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Contact

 

+44 (0)20 7594 1975p.vincent

 
 
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Location

 

211City and Guilds BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Corbett:2018:10.1016/j.jvs.2018.04.045,
author = {Corbett, RW and Grechy, L and Iori, F and Crane, J and Herbert, P and Di, Cocco P and Gedroyc, W and Vincent, PE and Caro, C and Duncan, N},
doi = {10.1016/j.jvs.2018.04.045},
journal = {Journal of Vascular Surgery},
pages = {152s--163s},
title = {Heterogeneity in the non-planarity and arterial curvature of arteriovenous fistulae in vivo},
url = {http://dx.doi.org/10.1016/j.jvs.2018.04.045},
volume = {68},
year = {2018}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Objective: Native arteriovenous fistulae (AVF) for haemodialysis are susceptible to non-maturation. Adverse features of local blood flow have been implicated in the formation of peri-anastomotic neointimal hyperplasia which may underpin non-maturation. While computational fluid dynamic simulations of idealised models highlight the importance of geometry on fluid and vessel wall interactions, little is known in vivo about AVF geometry and its role in adverse clinical outcomes. This study set out to examine the three-dimensional geometry of native AVF and the geometric correlates of AVF failure.Methods: As part of an observational study between 2013 and 2016, patients underwent creation of an upper limb AVF according to current surgical best practice. Phase-contrast MRI was performed on the day of surgery to obtain luminal geometry along with ultrasound measurements of flow. MRI datasets were segmented and reconstructed for quantitative and qualitative analysis of local geometry. Clinical maturation was evaluated at six weeks. Results: 60 patients were successfully imaged on the day of surgery. Radiocephalic (n=17), brachiocephalic (n=40) and brachiobasilic (n=3) fistulae were all included in the study. Centrelines extracted from segmented vessel lumen exhibited significant heterogeneity in arterial non-planarity and curvature. Furthermore, these features are more marked in brachiocephalic as compared to radiocephalic fistulae. Across the cohort, the projected bifurcation angle was was 73° (±16°) mean (±sd). Geometry was preserved at two weeks in 20 patients who underwent repeat imaging. A greater degree of arterial non-planarity (log odds ratio (logOR) 0.95 per 0.1/vessel diameter (95% CI 0.22 to 1.90, P= .03)) along with a larger bifurcation angle (logOR 0.05 per degree (95% CI 0.01 to 0.09, P= .02)) are associated with a great rate of maturation, as is fistula location (upper vs lower arm) logOR -1.9 (95% CI -3.2 to 0.7, P = .002) . Con
AU - Corbett,RW
AU - Grechy,L
AU - Iori,F
AU - Crane,J
AU - Herbert,P
AU - Di,Cocco P
AU - Gedroyc,W
AU - Vincent,PE
AU - Caro,C
AU - Duncan,N
DO - 10.1016/j.jvs.2018.04.045
EP - 163
PY - 2018///
SN - 0741-5214
SP - 152
TI - Heterogeneity in the non-planarity and arterial curvature of arteriovenous fistulae in vivo
T2 - Journal of Vascular Surgery
UR - http://dx.doi.org/10.1016/j.jvs.2018.04.045
UR - http://hdl.handle.net/10044/1/58848
VL - 68
ER -