A pressure drop and its oscillations occurring in the arteriovenous fistula due to sudden changes in the velocity vector direction or the transitional or turbulent flow, related to its complicated geometry, can exert a significant impact on the blood vessel wall behaviour. On the other hand, the pressure drop cannot be precisely measured in vivo with non-invasive measurement methods.
The aim of this study is to assess the pressure drop with numerical and experimental methods in the patient-specific fistula model taking into account a pulsating nature of the flow and the elasticity of blood vessel walls. An additional target is to find a correlation between these two methods.
FSI and in vitro simulations of the blood flow were performed for a patient-specific model of the fistula. Basic geometrical data of the correctly functioning mature fistula were obtained with angio-computed tomography. Those data were applied to develop a spatial CAD model of the fistula, which allowed for creating a virtual model for computer simulations and an analogous in vitro model made with rapid prototyping techniques. The material used to build the in vitro model is characterised by mechanical properties similar to the arterial tissue. A non-stationary computer simulation was carried out with an ANSYS software package, keeping as many flow similarities to the experiments carried out on the test stand as possible, and where the blood mimicking fluid was a water solution of glycerine. During the experiments, the static pressure was measured downstream and upstream of the anastomosis with precise pressure transducers.
The pressure drop was determined with the numerical and experimental methods, which take into account the elasticity of blood vessels. This is a novel approach, since most of similar studies were conducted on the assumption of rigid blood vessel walls. The obtained results show that the pressure drop within the fistula is not so high as reported in the literature, which is correlated with the precision of measurement methods and the fact that a large portion of the fluid energy is accumulated by the elastic walls.
