Hemodynamic study: impact of anastomosis floor arterial stenosis on neointimal hyperplasia in hemodialysis arteriovenous fistulas

作者：Yanling Zhang, Ya Zhan, Yajun Xiao, Chen Jiao, Weihong Bi, Ting Wang, Jian Liu · 发表于：Frontiers in Bioengineering and Biotechnology · 年份：2026 · DOI：10.3389/fbioe.2026.1706831 · 研究领域：Central Venous Catheters and Hemodialysis、Vascular Malformations and Hemangiomas、Diagnosis and Treatment of Venous Diseases

Objective: This study aimed to investigate the hemodynamic mechanisms associated with arterial stenosis at the anastomosis floor of arteriovenous fistula (AVF), with a particular focus on characterizing how varying degrees of stenosis affect hemodynamic parameters in downstream venous hyperplastic regions. Methods: Computational fluid dynamics (CFD) simulations were conducted to numerically analyze hemodynamic characteristics in AVF using a standardized idealized AVF model. Key hemodynamic parameters, such as wall shear stress (WSS) and oscillatory shear index (OSI), were quantitatively evaluated. Particular attention was given to the variations and spatial distribution of these parameters in the presence of stenotic lesions within the arterial wall at the anastomosis floor, as well as across varying severities of stenosis. Results: The regions of high wall shear stress in AVF are predominantly located at the anastomosis and along the outer wall of the juxta-anastomotic vein, whereas the low wall shear stress regions are primarily observed on the arterial wall at the floor of the anastomosis and along the inner wall of the swinging segment of the cephalic vein. These regions show partial consistency with the areas of high oscillatory shear index. In this idealized model, when the hyperplastic size of the artery at the anastomosis floor reaches approximately 1.0 mm, the wall shear stress level within the hyperplastic region returns to physiological levels, at which point neoin...