Systems and methods for simulation of hemodialysis access and optimization

1. A computer-implemented method of selecting hemodialysis access treatment options that reduce propensity for thrombosis, the method comprising:

receiving a pre-treatment patient-specific anatomic model comprising pre-treatment geometry of a patient's vasculature;

receiving a plurality of vascular access treatment options;

modifying the pre-treatment patient-specific anatomic model to generate, for each vascular access treatment option of the received plurality of vascular access treatment options, a respective patient-specific anatomic model of a post-treatment geometry, given the respective vascular access treatment option;

generating, for each patient-specific anatomic model of a post-treatment geometry, a computational model of a hemodynamic characteristic of the respective patient-specific anatomic model;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a value of the hemodynamic characteristic using the respective computational model, the hemodynamic characteristic including vessel shear stress and/or particle residence time through a vessel of the respective vascular access treatment option;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a propensity for thrombosis associated with the respective vascular access treatment option and one or more characteristics of the patient's blood;

generating and solving a cost function using the estimated value of the hemodynamic characteristic of each patient-specific anatomic model of a post-treatment geometry and the calculated propensity for thrombosis of each vascular access treatment option;

selecting, using the solved cost function, a vascular access treatment option for the patient, in which the propensity for thrombosis associated with the selected vascular access treatment option is lower than a propensity for thrombosis associated with a non-selected vascular access treatment option; and

outputting the selected vascular access treatment option to a user interface, the output including one of graphical, pictorial, and interactive features.

2. The computer-implemented method of claim 1 , further comprising:

reporting post-treatment blood pressure, blood velocity, perfusion pressure, blood flow, cardiac demand, or cardiac output of the patient based on the selected vascular access treatment option.

3. The computer-implemented method of claim 1 , further comprising:

receiving or determining a geometry of a vascular access treatment option of the plurality of vascular access treatment options; and

modifying the received pre-treatment patient-specific anatomic model such that the post-treatment geometry is based on the received or determined geometry of a vascular access treatment option.

4. The computer-implemented method of claim 1 , wherein the plurality of vascular access treatment options includes a graft.

5. The computer-implemented method of claim 1 , further comprising:

receiving or measuring one or more candidate locations for a vascular access treatment option of the plurality of vascular access treatment options;

determining the respective patient-specific anatomic model at at least one of the one or more candidate locations.

6. The computer-implemented method of claim 1 , wherein the cost function is generated and solved based on blood flow through vessels distal to a location of the respective vascular access treatment option.

7. The computer-implemented method of claim 1 , further comprising:

calculating the propensity for thrombosis by modeling particles advecting through a blood velocity field.

8. The computer-implemented method of claim 1 , wherein the cost function is generated and solved based on patient medical history.

9. A system for selecting hemodialysis access treatment options that reduce propensity for thrombosis, the system comprising:

a data storage device storing instructions for simulating or optimizing hemodialysis access; and

a processor configured to execute the instructions to perform a method including:

receiving a pre-treatment patient-specific anatomic model comprising pre-treatment geometry of a patient's vasculature;

receiving a plurality of vascular access treatment options;

modifying the pre-treatment patient-specific anatomic model to generate, for each vascular access treatment option of the received plurality of vascular access treatment options, a respective patient-specific anatomic model of a post-treatment geometry, given the respective vascular access treatment option;

generating, for each patient-specific anatomic model of a post-treatment geometry, a computational model of a hemodynamic characteristic of the respective patient-specific anatomic model;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a value of the hemodynamic characteristic using the respective computational model, the hemodynamic characteristic including vessel shear stress and/or particle residence time through a vessel of the respective vascular access treatment option;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a propensity for thrombosis associated with the respective vascular access treatment option and one or more characteristics of the patient's blood;

generating and solving a cost function using the estimated value of the hemodynamic characteristic of each patient-specific anatomic model of a post-treatment geometry and the calculated propensity for thrombosis of each vascular access treatment option;

selecting, using the solved cost function, a vascular access treatment option for the patient, in which the propensity for thrombosis associated with the selected vascular access treatment option is lower than a propensity for thrombosis associated with a non-selected vascular access treatment option; and

outputting the selected vascular access treatment option to a user interface, the output including one of graphical, pictorial, and interactive features.

10. The system of claim 9 , wherein the system is further configured for:

reporting post-treatment blood pressure, blood velocity, perfusion pressure, blood flow, cardiac demand, or cardiac output of the patient based on the selected vascular access treatment option.

11. The system of claim 9 , wherein the system is further configured for:

receiving or determining a geometry of a vascular access treatment option of the plurality of vascular access treatment options; and

modifying the received pre-treatment patient-specific anatomic model such that the post-treatment geometry is based on the received or determined geometry of a vascular access treatment option.

12. The system of claim 9 , wherein the plurality of vascular access treatment options includes a graft.

13. The system of claim 9 , wherein the system is further configured for:

receiving or measuring one or more candidate locations for a vascular access treatment option of the plurality of vascular access treatment options;

determining the respective patient-specific anatomic model at at least one of the one or more candidate locations.

14. The system of claim 9 , wherein the cost function is generated and solved based on blood flow through vessels distal to a location of the respective vascular access treatment option.

15. The system of claim 9 , wherein the system is further configured for:

calculating the propensity for thrombosis by modeling particles advecting through a blood velocity field.

16. The system of claim 9 , wherein the cost function is generated and solved based on patient medical history.

17. A non-transitory computer readable medium for use on a computer system containing computer-executable programming instructions for performing a method of selecting hemodialysis access treatment options that reduce propensity for thrombosis, the method comprising:

receiving a pre-treatment patient-specific anatomic model comprising pre-treatment geometry of a patient's vasculature;

receiving a plurality of vascular access treatment options;

modifying the pre-treatment patient-specific anatomic model to generate, for each vascular access treatment option of the received plurality of vascular access treatment options, a respective patient-specific anatomic model of a post-treatment geometry, given the respective vascular access treatment option;

generating, for each patient-specific anatomic model of a post-treatment geometry, a computational model of a hemodynamic characteristic of the respective patient-specific anatomic model;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a value of the hemodynamic characteristic using the respective computational model, the hemodynamic characteristic including vessel shear stress and/or particle residence time through a vessel of the respective vascular access treatment option;

calculating, for each vascular access treatment option of the received plurality of vascular access treatment options, a propensity for thrombosis associated with the respective vascular access treatment option and one or more characteristic of the patient's blood;

generating and solving a cost function using the estimated value of the hemodynamic characteristic of each patient-specific anatomic model of a post-treatment geometry and the calculated propensity for thrombosis of each vascular access treatment option;

selecting, using the solved cost function, a vascular access treatment option for the patient, in which the propensity for thrombosis associated with the selected vascular access treatment option is lower than a propensity for thrombosis associated with a non-selected vascular access treatment option; and

outputting the selected vascular access treatment option to a user interface, the output including one of graphical, pictorial, and interactive features.

18. The non-transitory computer readable medium of claim 17 , the method further comprising:

reporting post-treatment blood pressure, blood velocity, perfusion pressure, blood flow, cardiac demand, or cardiac output of the patient based on the selected vascular access treatment option.

19. The non-transitory computer readable medium of claim 17 , the method further comprising:

receiving or determining a geometry of a vascular access treatment option of the plurality of vascular access treatment options; and

modifying the received pre-treatment patient-specific anatomic model such that the post-treatment geometry is based on the received or determined geometry of a vascular access treatment option.

20. The non-transitory computer readable medium of claim 17 , wherein the plurality of vascular access treatment options includes a graft.