Grus T, Grusová G, Lambert L, Banerjee R, Matěcha J, Mlček M
Second Department of Surgery, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; Department of Radiology, General University Hospital in Prague, Prague, Czech Republic.
Physiol Res. 2016 Nov 8;65(4):591-595. doi: 10.33549/physiolres.933176. Epub 2016 Mar 15.
The geometric shape of the distal anastomosis in an infrainguinal bypass has an influence on its durability. In this article, we compared three different angles of the anastomosis with regard to the hemodynamics. Three experimental models of the distal infrainguinal anastomosis with angles of 25°, 45°, and 60° respectively were constructed according to the similarity theory to assess flow in the anastomoses using particle image velocimetry and computational fluid dynamics. In the toe, heel, and floor of the anastomosis that correspond to the locations worst affected by intimal hyperplasia, adverse blood flow and wall shear stress were observed in the 45° and 60° models. In the 25° model, laminar blood flow was apparent more peripherally from the anastomosis. In conclusions, decreasing the distal anastomosis angle in a femoropopliteal bypass results in more favorable hemodynamics including the flow pattern and wall shear stress in locations susceptible to intimal hyperplasia.
股腘以下旁路移植术中远端吻合口的几何形状对其耐久性有影响。在本文中，我们就血流动力学方面比较了三种不同角度的吻合口。根据相似理论构建了分别具有25°、45°和60°角度的三种股腘以下远端吻合口实验模型，以使用粒子图像测速技术和计算流体动力学来评估吻合口中的血流情况。在与内膜增生影响最严重部位相对应的吻合口趾侧、跟侧和底部，在45°和60°模型中观察到了不利的血流和壁面剪应力。在25°模型中，吻合口周围更外围处呈现层流血流。总之，在股腘旁路移植术中减小远端吻合口角度会导致更有利的血流动力学，包括在易发生内膜增生部位的血流模式和壁面剪应力。
