Blood flow through sutured and coupled microvascular anastomoses: a comparative computational study

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Fluid Dynamics

Background:

• Arterial anastomoses are crucial in vascular surgery.
• Sutured and coupled techniques are common, but their impact on blood flow and thrombosis risk is debated.

Purpose of the Study:

• To compare blood flow characteristics in idealized sutured versus coupled arterial anastomoses.
• To investigate flow parameters potentially linked to thrombus formation.

Main Methods:

• Computational fluid dynamics (CFD) modeling of blood flow in non-compliant arterial models.
• Simulation of Newtonian fluid flow in sutured and coupled anastomosis geometries.
• Analysis of velocity profiles, wall shear stress (WSS), and shear strain rate (SSR).

Main Results:

• Sutured anastomoses exhibited reduced boundary velocity, high WSS, and high SSR at suture sites.
• Coupled anastomoses showed a minor increase in WSS, significantly less than sutured models.
• Average WSS in coupled anastomoses was comparable to pristine vessels.

Conclusions:

• Sutured arterial anastomoses present a theoretically more thrombogenic profile compared to coupled anastomoses.
• Coupled anastomosis flow dynamics closely resemble those of a healthy, uninjured vessel.
• CFD analysis suggests sutured methods may carry a higher risk of thrombus formation.