Boundary layer separation in models of side-to-end arterial anastomoses.

We performed an investigation of boundary layer separation in models of side-to-end anastomoses, used clinically in axillofemoral and femorofemoral grafting. Boundary layer separation occurs when momentum causes a fluid to flow against a local pressure gradient. Models of side-to-end anastomoses were constructed from Dacron grafting material and from clear plastic blocks and tubing. Fluid energy loss across the anastomosis was small and physiologically insignificant. Local adverse pressure gradients were demonstrated near the anastomosis. Flow visualization studies demonstrated characteristic areas of boundary layer separation in the region of the adverse pressure gradients. The separation region involved both the main limb and the side arm. The separation forms a shell or ring of slow-moving fluid around the mainstream. Preliminary studies with pulsatile flow and with blood demonstrate that boundary layer separation occurs under clinical flow conditions. Boundary layer separation may play a role in the development of anastomotic hyperplasia and atherosclerotic deposits in the vicinity of surgical anastomoses.