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) . 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 . The spatial wall shear stress gradient (SWSSG) has been experimentally proven to cause proliferation and migration of the endothelial cells , resulting in an endothelial dysfunction that potentially leads to the initiation of IH.
A Genetic-Algorithm-Based Design Approach to Minimize Abnormal Hemodynamics Parameters at the End-to-Side Distal Anastomoses of Synthetic Bypass Grafts
El Zahab, Z, Divo, EA, & Kassab, AJ. "A Genetic-Algorithm-Based Design Approach to Minimize Abnormal Hemodynamics Parameters at the End-to-Side Distal Anastomoses of Synthetic Bypass Grafts." Proceedings of the ASME 2007 Summer Bioengineering Conference. ASME 2007 Summer Bioengineering Conference. Keystone, Colorado, USA. June 20–24, 2007. pp. 761-762. ASME. https://doi.org/10.1115/SBC2007-176718
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