A Longitudinal Study of Hemodynamics in a Functional Human Hemodialysis Fistula Using 3T Magnetic Resonance Imaging-Based Computational Fluid Dynamics Analysis

An arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis in end-stage renal disease. However, 60% of AVFs fail to achieve sufficient lumen dilation to allow adequate blood flow for chronic dialysis [1]. Although hemodynamics is likely an important modulator of AVF maturation and remodeling, the AVF hemodynamic spatial distribution profiles and their relationship with AVF maturation and remodeling are unclear [2]. Based on data collected from magnetic resonance imaging (MRI) of an AVF and computational fluid dynamics (CFD) simulations, we developed a protocol for longitudinal (over time) and noninvasive monitoring of geometry and hemodynamics of human AVF.