Arteriovenous fistula maturation and the influence of fluid dynamics. (November 2020)

• Record Type: Journal Article
• Authors: Colley, Eamonn; Simmons, Anne; Varcoe, Ramon; Thomas, Shannon; Barber, Tracie
• Other Names: Khir Ashraf W guest-editor.; Segers Patrick guest-editor.
• Is Part Of: Proceedings of the Institution of Mechanical Engineers. Volume 234:Number 11(2020)
• Page Start: 1197
• Page End: 1208
• Publication Date: 2020-11
• Subjects: Arteriovenous fistula -- vascular access -- dialysis -- hemodialysis; Biomedical engineering -- Periodicals; Medical instruments and apparatus -- Periodicals; 610.28
• DOI: 10.1177/0954411920926077
• Languages: English
• ISSNs: 0954-4119

Abstract

Arteriovenous fistula creation is the preferred vascular access for haemodialysis therapy, but has a large failure rate in the maturation period. This period generally lasts 6 to 8 weeks after surgical creation, in which the vein and artery undergo extensive vascular remodelling. In this review, we outline proposed mechanisms for both arteriovenous fistula maturation and arteriovenous fistula failure. Clinical, animal and computational studies have not yet shown a definitive link between any metric and disease development, although a number of theories based on wall shear stress metrics have been suggested. Recent work allowing patient-based longitudinal studies may hold the key to understanding arteriovenous fistula maturation processes.