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 -