Numerical investigation of hemodynamics at an end-to-side junction with a laterally diffused bypass graft

Intimal hyperplasia (IH) at arterial bypass graft is a major factor responsible for graft failure. Several techniques are used to explain IH formation at the end-to-side anastomosis junction. Abnormal hemodynamics contributing to the development of disease at the junction is the one of most common theories. This study describes a means of modifying the area of bypass graft at the junction part. This procedure, called the laterally diffused bypass graft (LDBG), is able to alter the hemodynamics in the end-to-side anastomosis. The LDBG model, due to an expansion of the outer curvature in the graft, reduces the velocity on the artery bed, side and top junction walls. The recirculation with velocity vectors on the host artery is significantly altered near the heel region on the host artery. Wall shear stress is decreased by up to 34% on the floor of artery centerline at the peak systole and by 61.9% on the top junction of artery during the systole deceleration. Corresponding time-averaged wall shear stresses are found to decrease by 40.5%. Secondary flow is observed to be decreased significantly at the distal junction.