Blood Flow in End-to-Side Anastomoses*

Blood flow in end-to-side autogenous or prosthetic graft anastomoses is of great interest to biomedical researchers because the biomechanical force profile engendered by blood flow disturbances at such geometric transitions is thought to play a significant role in vascular remodeling and graft failure. Thus, investigators have extensively studied anastomotic blood flow patterns in relation to graft failure with the objective of enabling the design of a more optimal graft anastomotic geometry. In contrast to arterial bifurcations, surgically created anastomoses can be modified to yield a flow environment that improves graft longevity. Understanding blood flow patterns at anastomotic junctions is a challenging problem because of the highly varying and complex three-dimensional nature of the geometry that is subjected to pulsatile and, occasionally, turbulent flow.