Vascular Cast to Program Antistenotic Hemodynamics and Remodeling of Vein Graft. Issue 10 (2nd February 2023)

• Record Type: Journal Article
• Authors: Ha, Hyunsu; Park, Ju Young; Lee, Chan Hee; Son, Deok‐Hyeon; Chung, Soon Won; Baek, Sewoom; Lee, Kyubae; Lee, Kang Suk; Yi, Se Won; Kang, Mi‐Lan; Kim, Dae‐Hyun; Sung, Hak‐Joon
• Is Part Of: Advanced science. Volume 10:Issue 10(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-02-02
• Subjects: antistenosis -- artery‐vein graft -- bridge structure -- computational simulation -- elastic fixity -- vascular wall device; Science -- Periodicals; 505
• DOI: 10.1002/advs.202204993
• Languages: English
• ISSNs: 2198-3844

Abstract

Abstract: The structural stability of medical devices is established by managing stress distribution in response to organ movement. Veins abruptly dilate upon arterial grafting due to the mismatched tissue property, resulting in flow disturbances and consequently stenosis. Vascular cast is designed to wrap the vein‐artery grafts, thereby adjusting the diameter and property mismatches by relying on the elastic fixity. Here, a small bridge connection in the cast structure serves as an essential element to prevent stress concentrations due to the improved elastic fixity. Consequently, the vein dilation is efficiently suppressed, healthy (laminar and helical) flow is induced effectively, and the heathy functions of vein grafting are promoted, as indicated by the flow directional alignment of endothelial cells with arterialization, muscle expansion, and improved contractility. Finally, collaborative effects of the bridge drastically suppress stenosis with patency improvement. As a key technical point, the advantages of the bridge addition are validated via the computational modeling of fluid–structure interaction, followed by a customized ex vivo set‐up and analyses. The calculated effects are verified using a series of cell, rat, and canine models towards translation. The bridge acted like "Little Dutch boy" who saved the big mass using one finger by supporting the cast function. Abstract : When veins and arteries are grafted in patients undergoing hemodialysis or vascular disease, the veins abruptly dilate abruptly owing to the weak mechanical properties to handle arterial flow and pressure. Vein dilation causes blood flow disturbance and vessel occlusion. The vascular cast externally wraps the arteriovenous graft by covering the connection part to manage the dilation changes and prevents vascular occlusion.