Biomechanical, morphological and zero-stress state characterization of jugular vein remodeling in arteriovenous fistulas for hemodialysis

Kritharis, EP; Kakisis, JD; Giagini, AT; Manos, T; Stergiopulos, N; Tsangaris, S; Sokolis, DP

dc.contributor.author	Kritharis, EP	en
dc.contributor.author	Kakisis, JD	en
dc.contributor.author	Giagini, AT	en
dc.contributor.author	Manos, T	en
dc.contributor.author	Stergiopulos, N	en
dc.contributor.author	Tsangaris, S	en
dc.contributor.author	Sokolis, DP	en
dc.date.accessioned	2014-03-01T02:00:02Z
dc.date.available	2014-03-01T02:00:02Z
dc.date.issued	2010	en
dc.identifier.issn	0006-355X	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/29075
dc.subject	e-PTFE distal vein anastomosis	en
dc.subject	histology	en
dc.subject	shear stress	en
dc.subject	intramural stress	en
dc.subject	residual stress	en
dc.subject.classification	Biophysics	en
dc.subject.classification	Engineering, Biomedical	en
dc.subject.classification	Hematology	en
dc.subject.other	ANASTOMOTIC INTIMAL HYPERPLASIA	en
dc.subject.other	INDUCED ARTERIAL ENLARGEMENT	en
dc.subject.other	ELASTIC PROPERTIES	en
dc.subject.other	MECHANICAL-PROPERTIES	en
dc.subject.other	HYPERTENSIVE PATIENTS	en
dc.subject.other	MEDIAL HYPERPLASIA	en
dc.subject.other	CAROTID-ARTERY	en
dc.subject.other	OPENING ANGLE	en
dc.subject.other	GRAFT MODEL	en
dc.subject.other	LOOP GRAFTS	en
dc.title	Biomechanical, morphological and zero-stress state characterization of jugular vein remodeling in arteriovenous fistulas for hemodialysis	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2010	en
heal.abstract	While the role of hemodynamic variables on the development of intimal hyperplasia in arteriovenous fistulas for hemodialysis has been examined, less is known about the intramural biomechanical factors. In this study, arteriovenous fistulas were created by implantation of e-PTFE grafts between carotid artery and jugular vein in healthy pigs. In vivo recordings exhibited a three-fold pressure and flow elevation in grafted veins after fistula creation, remaining so until sacrifice. The chief morphological observation in grafted vessels was wall thickening at two weeks, serving to restore intramural stresses to homeostatic levels, and a less marked internal diameter enlargement, gradually normalizing intimal shear after four weeks. The residual strains and opening angle, specifying the zero-stress configuration, increased with differences reaching significance at twelve weeks. Association with histomorphological findings on intima, media and adventitia growth disclosed a correlation between intimal hyperplasia and opening angle increase. Elastin and cellular contents diminished opposite to collagen content, most differences occurring within the first four weeks after grafting. Inflation/extension testing showed that post-fistula the vein wall became progressively thicker and stiffer, lacking restoration of compliance to baseline levels. The present data may further our understanding of the dynamics of venous biomechanical remodeling under pressure and flow-overload conditions.	en
heal.publisher	IOS PRESS	en
heal.journalName	BIORHEOLOGY	en
dc.identifier.isi	ISI:000288321700003	en
dc.identifier.volume	47	en
dc.identifier.issue	5-6	en
dc.identifier.spage	297	en
dc.identifier.epage	319	en