Song Liu1,2,3This email address is being protected from spambots. You need JavaScript enabled to view it., Yaqin Wang4, Yi Wang2, Jun Su3, Bingrong Liu2, and Ling Peng2
1School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, 300072 Tianjin, China
2Jiangxi Sanxin Medical Technology Co., Ltd, 330052 Nanchang, China
3Jiangxi Shengdankang Medical Technology Co., Ltd, 330115 Nanchang, China
4Jiangxi General Institute of Testing and Certification, 330052 Nanchang, China
Received: November 21, 2024 Accepted: March 31, 2025 Publication Date: April 30, 2025
Copyright The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.
Objective: To investigate the common complications of arteriovenous fistula (AVF) puncture during hemodialysis, to deeply study the mechanical mechanism of the puncture process, and to provide a theoretical basis for optimizing puncture techniques and designing new puncture devices. Methods: The puncture process was divided into five stages, and the force conditions of each stage were analyzed. Mechanical models of puncture resistance, friction, and cutting force were established. Finite element simulation was used to simulate the stress distribution under different puncture conditions. An AVF puncture experimental platform was built to collect mechanical data under different puncture parameters, and the simulation results were verified. Results: The simulation and experimental results showed that the smaller the diameter of the puncture needle, the smaller the puncture force. Within the puncture angle range of 15-30°, the puncture force increased with the increase of the angle, reaching a peak at 30°. The puncture speed had little effect on the puncture force within the range of 1-5 mm/s. In clinical practice, for patients with thinner vascular walls, a puncture needle with a diameter of less than 1 mm should be selected, and a puncture angle of 25-30° should be used. Conclusion: This study reveals the mechanical characteristics of the AVF puncture process and provides theoretical guidance for optimizing puncture techniques and reducing the risk of complications. The research results can provide key parameters for the development of hemodialysis AVF puncture robots.
[1] S.Korsheed, M.T.Eldehni, S. G. John, R. J. Fluck, and C. W. McIntyre, (2011) “Effects of arteriovenous fistula formation on arterial stiffness and cardiovascular performance and function" Nephrology Dialysis Transplantation 26(10): 3296–3302. DOI: 10.1093/ndt/gfr851.
[2] N. Kahraman and D. Demir, (2019) “Outcomes of arteriovenous fistula reconstruction in vascular access dysfunction" American Journal of Translational Research 11(2): 1058–1065.
[3] T. He, C. Guo, and L. Jiang, (2023) “Puncture site decision method for venipuncture robot based on near infrared vision and multiobjective optimization" Science China Technological Sciences 66: 13–23. DOI: 10. 1007/s11431-022-2233-5.
[4] K. Cheng, L. Li, Y. Du, J. Wang, Z. Chen, J. Liu, et al., (2023) “A systematic review of image-guided, surgical robot-assisted percutaneous puncture: Challenges and benefits" Mathematical Biosciences and Engineering 20(5): 8375–8399. DOI: 10.3934/mbe.2023367.
[5] X. He, Y. Xiao, X. Zhang, X. Zhang, X. Zhang, Y. Wei, et al., (2024) “Low-dose CT fluoroscopy-guided interven tional minimally invasive robot" Heliyon 10(7): DOI: 10.1016/j.heliyon.2024.e28914. \
[6] T. Li, Q. Zeng, J. Li, C. Qian, H. Yu, J. Lu, et al., (2024) “An Adaptive Control Method and Learning Strategy for Ultrasound-Guided Puncture Robot" Electronics 13(3): DOI: 10.3390/electronics13030580.
[7] B. Stegmayr, C. Willems, T. Groth, A. Martins, N. M. Neves,K.Mottaghy,etal., (2021)“Arteriovenous access in hemodialysis: A multidisciplinary perspective for future solutions" The International Journal of Artificial Organs 44(1): 3–16. DOI: 10.1177/0391398820922231.
[8] V. Loizeau, H. Tanouti, A. Marcheguet, G. Loubière, P. Aegerter, H. Drioueche, et al., (2023) “Effect of nee dle orientation during arteriovenous access puncture on needed compression time after hemodialysis: A randomized controlled trial" Hemodialysis International 27(4): 364–369. DOI: 10.1111/hdi.13105.
[9] U.Yilmaz,A.Unal,S.Gul,G.Demirtas,A.Inci,andY. Sahinturk, (2022) “Using two-holed needles for both arterial and venous accesses to the arteriovenous fistula to im prove flow during hemodialysis" Therapeutic Aphere sis and Dialysis 26(1): 191–196. DOI: 10.1111/1744 9987.13689.
[10] Y. Bentata, F. Hamdi, H. Al Zaarir, M. T. Abualtayef, I. Haddiya, A. Benzirar, et al., (2021) “Cutaneous necro sis of the arteriovenous fistula puncture site in chronic hemodialysis: A historical complication or an ever-present threat? A series of 26 cases" Hemodialysis International 25(1): 29–34. DOI: 10.1111/hdi.12888.
[11] Y. Kobayashi, R. Hamano, H. Watanabe, et al., (2014) “Preliminary in vivo evaluation of a needle insertion manipulator for central venous catheterization" ROBOMECH Journal 1(1): 18. DOI: 10.1186/s40648-014-0018-3.
[12] W. Liu, Z. Yang, P. Li, J. Zhang, and S. Jiang, (2019) “Mechanics of tissue rupture during needle insertion in transverse isotropic soft tissue" Medical & Biological Engineering & Computing 57(6): 1353–1366. DOI: 10.1007/s11517-019-01955-6.
[13] F. Gao, Q. Song, Z. Lv, et al., (2021) “Study on the influence of surface characteristics of medical puncture needles on the puncture process" Journal of Mechanical Engineering 57(11): 44–51. DOI: 10.3901/JME.2021.11.044.
[14] M. Mahvash and P. E. Dupont. “Fast Needle Insertion to Minimize Tissue Deformation and Damage”. In: Proceedings of the IEEE International Conference on Robotics and Automation. 2009, 3097. DOI: 10.1109/ROBOT.2009.5152403.
[15] X. Bao, W. Li, M. Lu, et al., (2016) “Experiment Study on Puncture Force Between MIS Suture Needle and Soft Tissue" Biosurface and Biotribology 2(2): 49. DOI: 10.1016/j.bsbt.2016.05.001.
[16] O. A.Shergold and N. A. Fleck, (2005) “Experimental Investigation Into the Deep Penetration of Soft Solids by Sharp and Blunt Punches, with Application to the Piercing of Skin" Journal of Biomechanical Engineering 127(5): 838. DOI: 10.1115/1.1992528.
[17] T. S. Lendvay, F. J. Hsieh, B. Hannaford, and J. Rosen. “Thebiomechanicsofpercutaneousneedleinsertion”. In: Proceedings of the 16th Conference on Medicine Meets Virtual Reality. 2008, 245–247.
[18] X. Wang, J. Xia, J. H. Park, X. Xie, and G. Chen, (2024) “Event-Triggered Adaptive Tracking With Guaran teed Transient Performance for Switched Nonlinear Systems Under Asynchronous Switching" IEEE Transactions on Cybernetics 54(1): 496–505. DOI: 10.1109/ TCYB.2022.3223983.
[19] X.Wang, J. Xia, J. H. Park, X. Xie, and G. Chen, (2022) “Intelligent Control of Performance Constrained Switched Nonlinear Systems With Random Noises and Its Application: An Event-Driven Approach" IEEE Transactions on Circuits and Systems I: Regular Papers 69(9): 3736–3747. DOI: 10.1109/TCSI.2022.3175748.
We use cookies on this website to personalize content to improve your user experience and analyze our traffic. By using this site you agree to its use of cookies.
