Consensus threshold for aberrant venous wall shear stress in AV graft evaluation

Establish a consensus, physiologically justified quantitative threshold for low wall shear stress that characterizes aberrant hemodynamics associated with venous neointimal hyperplasia and graft dysfunction in arteriovenous grafts, resolving the current variability across computational studies.

Background

Wall shear stress (WSS) is central to assessing haemodynamic risk in arteriovenous grafts, with low WSS linked to neointimal hyperplasia and high WSS associated with endothelial injury. However, the literature employs disparate low-WSS thresholds, complicating cross-paper comparisons and clinical translation.

In defining their metrics, the authors explicitly note the absence of a community consensus on what numeric threshold constitutes aberrant WSS. They adopt threshold values based on average venous and arterial measurements but emphasize that current practice varies widely in in silico studies.