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Updated: Jul 28, 2025
Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
Published on: July 11, 2019
Patient-specific hemodynamic feature of central venous disease intervened by stent: A numerical study
Zhaoli Wang1, Tao Li2, Jingyuan Zhou1
1Department of Applied Mechanics, Sichuan University, Chengdu, China.
Insights
Double stent placement improves flexibility and radial stiffness in central venous disease patients undergoing hemodialysis. This computational fluid dynamics study offers a theoretical basis for optimizing stent interventions in hemodialysis access.
Area of Science:
- Biomedical Engineering
- Medical Imaging
- Cardiovascular Research
Background:
- Central venous disease (CVD) with stenosis or occlusion is a common complication in chronic hemodialysis (HD) patients, leading to dialysis access dysfunction.
- Percutaneous transluminal angioplasty with stent placement (PTS) is a primary treatment for CVD, with additional stents used if initial efficacy is insufficient.
Purpose of the Study:
- To evaluate the therapeutic effect of different PTS schemes for central venous disease in hemodialysis patients.
- To compare the hemodynamic characteristics of patients after single versus multiple stent placements using computational fluid dynamics (CFD).
Main Methods:
- Three-dimensional central vein models were constructed from computational tomography angiography (CTA) images of four HD patients.
- CFD simulations were performed using two inlet velocity modes to mimic healthy and HD blood flow rates.
- Hemodynamic parameters including wall shear stress (WSS), velocity, and helicity were analyzed for different stent configurations.
Main Results:
- The implantation of double stents demonstrated improved flexibility compared to single stents.
- Double stents exhibited superior radial stiffness when subjected to external forces.
- CFD analysis provided insights into the hemodynamic impact of varying stent configurations.
Conclusions:
- Double stent placement appears to enhance the mechanical properties of the central vein in hemodialysis patients.
- This study provides a theoretical foundation for optimizing stent interventions in managing central venous disease for hemodialysis access.
- CFD modeling is a valuable tool for evaluating the efficacy of PTS schemes in CVD treatment.
Abstract:
Central venous disease (CVD) with stenosis or occlusion is a severe and prevalent complication for chronic hemodialysis (HD) patients, resulting in dialysis access dysfunction. Percutaneous transluminal angioplasty with stent placement (PTS) has become one of the first-line treatments for CVD. In clinical practice, the extra stents would be used if the curative efficacy of a single stent were unsatisfactory. Aiming to evaluate the therapeutic effect of different PTS schemes, computational fluid dynamics (CFD) simulations on four patients were performed to compare the hemodynamic characteristics of real-life HD patients after stent placement. The three-dimensional central vein's models of each patient were built using computational tomography angiography (CTA) images, and idealized models were constructed as contrast. Two inlet velocity modes were imposed to imitate the blood flow rate of healthy and HD patients. The hemodynamic parameters for different patients were investigated, including wall shear stress (WSS), velocity, and helicity. The results showed that the implantation of double stents is able to improve flexibility. When subjected to external force, the double stents have better radial stiffness. This paper evaluated the therapeutic efficacy of stent placement and provided a theoretical basis for CVD intervention in hemodialysis patients.
