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Abstract

In this doctoral dissertation, we expand on how we engineered replicas of vein geometries prone to pathologic vein lumen narrowing and blood clot formation, also known as stenosis and thrombosis, respectively, in end-stage renal disease patients undergoing hemodialysis treatment. Our main goal is to develop millifluidic technology that serves as a research tool to study patient-specific hemodynamics in vitro which can potentially help elucidate vascular pathogenesis mechanisms. Here, we elaborate on how we created cephalic vein computational models of our patient cohort to explore hemodynamics via computational fluid dynamics flow simulations. Moreover, we show how we fabricated millifluidic devices parting from these cephalic vein computational models to experimentally characterize hemodynamics under healthy physiologic flow rates. Alas, future efforts to mimic pathologic flow conditions for hemodynamics characterization will help us contrast resulting wall shear stress from that obtained from healthy flow conditions to better understand stenosis and thrombosis in the cephalic vein arch.The developed and patented technology presented here would allow for systematic dissection of stenosis and thrombosis contributing factors in order to shed light onto the heterogeneity in vascular complications and vascular access outcomes during hemodialysis. Moreover, these devices could also contribute to the discovery of more efficient anti-thrombotic and thrombolytic medication that ultimately serves our mission; to improve the quality of life of hemodialysis patients by understanding and preventing clotting complications and advance vascular clinical care.

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