MedicineSurgeryBiocompatibilityHemostasisVascular SurgeryHemodynamicsVascular AnastomosisArterial ComplianceEnd-to-side Vascular AnastomosisFlow-through AnastomosisSuture Line ComplicationsSynthetic Vascular GraftsVascular Anastomotic ComplicationsVascular Mechanics
Compliance mismatch between host arteries and synthetic grafts is rarely cited as a cause of suture line disruption and endothelial/platelet damage. The study investigates how compliance mismatch predisposes to anastomotic rupture, flow‑induced shear stress, and reduced distal perfusion. Matching graft compliance to the host artery minimizes anastomotic rupture, flow‑induced shear stress, and distal perfusion loss, as flow separation at the distal anastomosis generates shear that damages endothelial cells and platelets.
Compliance mismatch between host artery and synthetic vascular substitutes has rarely been mentioned in the literature as a possible cause of suture line disruption and damage to endothelial and platelet cells. In this paper we have attempted to elucidate on how compliance mismatch can predispose: (1) anastomotic rupture, (2) flow induced shear stres and, (3) reduced distal perfusion. We have concluded that in order to minimize all three of these factors the compliance of the vascular substitute should be equivalent to the host artery to which it is to be anastomosed. It appears that the factor which is most seriously affected by the compliance mismatch is the flow regimen in that flow separation regions forms at the distal anastomosis. Shear stresses, due to eddies in these regions of flow separation, are of significant magnitude to destroy endothelial cells lining the vascular wall and platelets existing in the boundary layer.