HAEMODYNAMIC AND STRUCTURAL FEATURES OF DIFFERENT TYPES OF ARTERIOVENOUS ANASTOMOSES IN RABBITS AND THEIR MATHEMATICAL JUSTIFICATION
V.O. Voronych1, O.Ya. Popadyuk1, R.I. Merena1, O.H. Popadynets1, R.R. Barchuk1, L.V. Sobol1
- Ivano-Frankivsk National Medical University, Ukraine
DOI: https://doi.org/10.15407/fz72.02.082

Abstract
The duration of arteriovenous anastomoses functioning is
influenced by haemodynamic conditions and the properties of
the formed vascular access, which determine the mechanisms
of vascular wall restructuring, neointima formation, lumen
remodelling, and stenosis development. The aim of the study:
mathematical justification of the haemodynamic and structural
features of different types of arteriovenous anastomoses.
Arteriovenous anastomoses between the common carotid
artery and the external jugular vein of two types were formed
in rabbits: end-to-side (1st group) and end-to-side with the
use of venous tributaries (2nd group). It has been confirmed
that variations in the geometry of the anastomosis affect
the amount of blood circulation by altering its diameter.
The peculiarities of local blood flow directly determine the
restructuring of the endothelium and smooth muscle cells. The
calculated blood flow velocity in the arterial and venous parts
of the anastomoses corresponds to the values established by
ultrasound examination within two hours after the formation
of vascular access. The obtained data reflect haemodynamic
parameters in the early period after fistula formation, before
blood flow is enhanced by vasodilation and a decrease in
peripheral vascular resistance. Such a level of haemodynamic
load is sufficient to trigger a cascade of adaptive remodelling
of the venous wall and its transition to an arterial phenotype,
without creating excessive mechanical stress associated
with the risk of intimal hyperplasia. The established data of
haemodynamic indexes confirm the physiological validity
of the developed models and provide a basis for further
comparison of the calculated indicators with actual ultrasound
values and morphological features of vascular access at
different stages of fistula maturation. The proposed analytical
interpretation is consistent with established haemodynamic
indexes, as well as the structural organisation of vessels and
ultrastructural changes in the endothelium of the formed
anastomosis. The developed mathematical model enables the
prediction of vascular access haemodynamics features, the
selection and justification of a specific connection type, and
the assessment of structural damage risks and the probability
of their development.
Keywords:
arteriovenous anastomosis; haemodynamics; structural features; mathematical justification
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