From the School of Mechanical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
Division of Vascular and Transplant Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
ASAIO J. 2021 Jul 1;67(7):817-824. doi: 10.1097/MAT.0000000000001315.
A hemodialysis (HD) catheter, especially one with a symmetric tip design, plays an important role in the long-term treatment of patients with renal failure. It is well known that the design of the HD catheter has a considerable effect on blood recirculation and thrombus formation around it, which may cause inefficiencies or malfunctions during HD. However, hemodynamic analyses through parametric studies of its designs have been rarely performed; moreover, only comparisons between the existing models have been reported. In this study, we numerically analyzed the design of the HD catheter's side hole and distal tip for evaluating their effects on hemodynamic factors such as recirculation rate (RR), shear stress, and blood damage index (BDI). The results indicated that a larger side hole and a nozzle-shaped distal tip can significantly reduce the RR and shear stress around the HD catheter. Furthermore, based on these hemodynamic insights, we proposed three new HD catheter designs and compared their performances with existing catheters using numerical and in vitro methods. These new designs exhibited lower RRs and BDI values, thus providing better performance than the existing models. These results can help toward commercialization of more efficient HD catheters.
血液透析（HD）导管，尤其是尖端对称设计的导管，在肾衰竭患者的长期治疗中起着重要作用。众所周知，HD 导管的设计对其周围的血液再循环和血栓形成有很大影响，这可能导致 HD 过程中的效率低下或故障。然而，通过对其设计的参数研究进行血流动力学分析的情况很少见；此外，仅报道了现有模型之间的比较。在这项研究中，我们通过数值分析了 HD 导管侧孔和远端尖端的设计，以评估它们对再循环率（RR）、剪切应力和血液损伤指数（BDI）等血流动力学因素的影响。结果表明，较大的侧孔和喷嘴状的远端尖端可以显著降低 HD 导管周围的 RR 和剪切应力。此外，基于这些血流动力学的见解，我们提出了三种新的 HD 导管设计，并使用数值和体外方法比较了它们与现有导管的性能。这些新设计的 RR 和 BDI 值较低，因此比现有模型具有更好的性能。这些结果有助于更高效的 HD 导管的商业化。
