Hemodynamics for the vascular surgeon.

Basic principles of fluid dynamics and material properties underlie many facets of the diagnosis, treatment, and natural history of vascular disease. I review the concepts of total fluid energy and both viscous and inertial energy losses with reference to arterial occlusive disease. I contrast the vascular wall properties of arteries and veins and discuss the relevance of mechanical principles to arterial aneurysm. I review the pathophysiologic features of small and large arteriovenous fistula. Finally, I discuss the altered dynamics associated with venous obstruction and valvular insufficiency in light of recent noninvasive diagnostic techniques that provide simple rapid assessment of venous pathophysiologic features.