Constitutive modeling of materials for vascular access in hemodialysis
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The vascular access is created as a point to collect and return blood for hemodialysis. It can be accomplished either by an arteriovenous fistula, a synthetic graft that is inserted between an artery and a vein, or by a central venous catheter. The connection between the artery and the vein is usually made in the upper limb. From a biomechanical perspective, this involves the arterialization of the vein, i.e. the vein is exposed to elevated blood pressure and flowrate. The mechanobiological reaction of the vein wall sometimes leads to failure of vascular access. The vascular access may also become scarred by repeated punctures or an aneurysm may form. The long-term goal of our research is to perform a parametric simulation of Fluid-Structure Interaction in the vascular access to reveal the mechanical conditions to which the vein wall is exposed here. These results should contribute to the understanding of the conditions under which vascular access fails. To obtain input data for modeling vascular access, we performed tensile tests with basilic vein samples and ePTFE grafts. The resulting stress-strain curves were fitted with an anisotropic hyperelastic constitutive model of exponential type. The data show that the ePTFE material, although anisotropic and nonlinear in its response similar to the vessel wall, is much stiffer, which could contribute to the failure of vascular access based on synthetic graft.
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