تحلیل زمان‌مند فیستول در سه زاویه پیوند 45، 90 و 135 درجه

نوع مقاله : مقاله پژوهشی

نویسندگان

تربیت مدرس

چکیده

انتخاب زاویه‌ی پیوند مناسب برای ایجاد فیستول برای جراحان از اهمیت بالایی برخوردار است؛ بنابراین در این پژوهش سه زاویه‌ی پیوند 45، 90 و 135 درجه به نمایندگی زوایای حاده و منفرجه، طراحی و در یک سیکل کامل قلبی شبیه‌سازی و مورد بررسی قرار گرفتند. از مدل خون غیرنیوتونی کاریو استفاده شده و جریان تراکم‌ناپذیر در نظر گرفته شد و پارامترهای مهم همانند تنش برشی میانگین، شاخص برشی نوسانی، زمان اقامت نسبی و بیشینه‌ی افت فشار استخراج شده و در زوایای مختلف مقایسه شدند. با بررسی نتایج مشاهده شد که تنش برشی میانگین و همچنین ناحیه‌ی درگیر در تنش برشی بالا در زاویه‌ی پیوند 135 درجه نسبت به دو زاویه‌ی دیگر کمتر است و احتمال بروز بیماری ترومبوز و زخم در این زاویه کاهش می‌یابد. از آنجایی که %80 علت ناکارآمدشدن فیستول ناشی از بیماری ترومبوز می‌باشد؛ بنابراین این زاویه به عنوان زاویه‌ی مناسب‌تری برای ایجاد فیستول انتخاب می‌شود. با توجه به نتایج زمان اقامت نسبی که مناطق مستعد رسوب را نشان می‌دهد مشخص شد که در سه زاویه‌ی پیوند، شاخه‌ی سمت راست فیستول و نواحی جدایش جریان مستعد گرفتگی می‌باشند و احتمال رسوب در پیوند 135 درجه و در زیر محل پیوند نسبت به دو زاویه‌ی دیگر کاهش می‌یابد. همچنین این زاویه کمترین افت فشار را بین ورودی اصلی و خروجی فیستول دارد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Temporal analysis of the fistula at three anastomosis angles of 45, 90, and 135 degrees

نویسندگان [English]

  • seyed mohamad naderi
  • Ghassem Heidarinejad
  • mohamad safarzadeh
tarbiat modares
چکیده [English]

Selection of the appropriate anastomosis angle for the creation of a fistula for surgery is very important. Therefore, in this study, three anastomosis angles of 45, 90, and 135 degrees, representing acute and obtuse angles, are designed and simulated in a complete pulsation cycle. Carreau non-Newtonian blood model is used and the flow is considered as incompressible flow. Finally, after modeling, important parameters such as mean shear stress on the fistula wall, oscillatory shear index, relative residence time, and maximum pressure drop are extracted and compared at different angles. After comparing the results, it is observed that the time average wall shear stress and the range of the high shear stress at anastomosis angle of 135 degree is lower than the two other angles and the probability of thrombosis disease in this angle is reduced. 80% of fistula failure is caused by thrombosis disease, therefore this angle is chosen as the most appropriate angle for fistula creation. Based on the results of the relative residence time, it is found that at all three angles of anastomosis, the right branch of the fistula and flow separation sites have a probability of sedimentation and it decreases at an angle of 135 degree. This angle also has the lowest pressure drop between the main inlet and the fistula outlet.

کلیدواژه‌ها [English]

  • Hemodialysis
  • fistula anastomosis angle
  • thrombosis
  • heart pulsation cycle
  • atherosclerosis
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