Substitution-rate based screening model to assess stenosis progression in experimental stenotic arteriovenous grafts

Chung Dann Kan, Wei Ling Chen, Chia Hung Lin, Ming Jui Wu, Yi Chen Mai

研究成果: Article同行評審

1 引文 斯高帕斯(Scopus)


An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model. In our practical measurements, we found that inflow and outflow channeled through a narrowed access indicated both pressure and resistance differences as the degree of stenosis (DOS) gradually increased. A substitution-rate matrix was conducted to replace bilateral pressure variations, while a transition probability matrix was calculated. Differences in transition probabilities were then used to distinguish between normal conditions and flow instabilities using the distance estimation method. The joint probability decayed from < 0.81 to 0.00 could be specified to identify the progression in stenosis levels from a DOS% = 50.0-95.0%. Average joint probabilities were found to be inversely related with the DOS using a non-linear regression (R>2 0.90). Hence, the joint probability could be specified as a critical threshold, < 0.81, to identify the severity stenosis level, DOS% 3/4 70%, in the assessment of coexisting inflow and outflow stenoses. Experimental results suggest that the proposed model is superior to hemodynamic analysis and traditional intelligent method, and can be used for dysfunction screening during HD treatment.

頁(從 - 到)887-902
期刊Technology and Health Care
出版狀態Published - 2017

All Science Journal Classification (ASJC) codes

  • 生物物理學
  • 生物工程
  • 資訊系統
  • 生物材料
  • 生物醫學工程
  • 健康資訊學


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