A Genetic-Algorithm-Based Design Approach to Minimize Abnormal Hemodynamics Parameters at the End-to-Side Distal Anastomoses of Synthetic Bypass Grafts

Medical records on post-operative performances of synthetic bypass grafting show poor results due to the re-stenosis occurring at the end-to-side distal (ETSD) anastomoses of the grafts. The re-stenosis is mainly caused by intimal hyperplasia (IH) [1]. A major factor behind the anastomotic IH development is the non-physiological flow patterns, such as separation and re-attachment, resulting from the bifurcating nature of the anastomotic geometry [2]. The spatial wall shear stress gradient (SWSSG) has been experimentally proven to cause proliferation and migration of the endothelial cells [3], resulting in an endothelial dysfunction that potentially leads to the initiation of IH.