Roussis P C, Giannakopoulos A E, Charalambous H P
Department of Civil & Environmental Engineering, University of Cyprus, 75 Kallipoleos, Nicosia, Cyprus.
Department of Civil Engineering, University of Thessaly, Pedion Areos, 38334, Vólos, Greece.
Cardiovasc Eng Technol. 2015 Mar;6(1):36-48. doi: 10.1007/s13239-014-0206-6. Epub 2014 Dec 10.
End-to-side vascular anastomosis has a considerable complexity regarding the suturing of the juncture line between the artery and the graft. The present study proposes a stress-concentration methodology for the prediction of the stress distribution at the juncture line, aiming to provide generic expressions describing the response of an end-to-side anastomosis. The proposed methodology is based on general results obtained from the analysis of pipe connections, a topic that has been investigated in recent years in the field of offshore structural engineering. A key aspect for implementing the stress-concentration-factor approach is the recognition that the axial load due to pressure and flow dynamics exerted along the graft axis controls the "hot spots" on the juncture line, which in turn affects the mechanical response of the sutures. Several parameters, identified to influence the suture line response, are introduced in closed-form expressions for the suture line response calculations. The obtained results compare favorably with finite element results published in the literature. The proposed model predicts analytically the suture line response of end-to-side anastomosis, while capturing the influence of and interdependence among the problem parameters. Lower values of the graft radius, the distance between sequential stitches, and the intersecting angle between the artery and the graft are some of the key parameters that reduce the suture line response. The findings of this study are broad in scope and potentially applicable to improving the end-to-side anastomosis technique through improved functionality of the sutures and optimal selection of materials and anastomosis angle.
端侧血管吻合术在动脉与移植物之间的接合线缝合方面具有相当大的复杂性。本研究提出了一种应力集中方法，用于预测接合线处的应力分布，旨在提供描述端侧吻合术响应的通用表达式。所提出的方法基于对管道连接分析获得的一般结果，这是近年来海洋结构工程领域研究的一个课题。实施应力集中系数方法的一个关键方面是认识到沿移植物轴线施加的由于压力和流动动力学引起的轴向载荷控制着接合线上的“热点”，这反过来又影响缝线的力学响应。在用于缝线响应计算的封闭形式表达式中引入了几个被确定为影响缝线响应的参数。所得结果与文献中发表的有限元结果相比具有优势。所提出的模型通过解析预测端侧吻合术的缝线响应，同时捕捉问题参数之间的影响和相互依赖性。移植物半径、连续缝线之间的距离以及动脉与移植物之间的相交角度的较低值是降低缝线响应的一些关键参数。本研究的结果范围广泛，可能适用于通过改善缝线功能以及材料和吻合角度的优化选择来改进端侧吻合术技术。
