Experience of Patient-Specific CFD Simulation of Blood Flow in Proximal Anastomosis for Femoral-Popliteal Bypass

Round 1

Reviewer 1 Report

Several studies have highlighted the applicative importance of CFD simulation of blood flow in predicting the most appropriate packaging characteristics of the surgical anastomoses of the femoro-popliteal bypass.

These aspects have proved important in order to prevent the risk of developing intimal hyperplasia and, therefore, the longevity of the graft itself.

The study is well characterized under the descriptive profile of the objectives; the introductory part is also, in my opinion, also verbose; in this sense the descriptive part that cites the bibliographic references 14-18, 22-25 and 26-28 could be more effectively reported in the discussion.

The methodology is described clearly and rigorously with widely understandable terms. The methods of angio-CT study and echocolor Doppler study are subject to detailed description as regards the techniques used and the parameters recorded, with the relative acquisition formulas.

The ANSYS CFX package application was used in particular for the calculations with the options offered to solve the Navier-Stokes equations.

The results are well described and certainly interesting also from the clinical interpretative point of view. The attached iconographic support is very relevant with particular reference to Figs. 5, 6 and 7; in the latter the dynamic and velocimetric reconstruction for the application model n. 2 appears particularly effective.

In this context, the introduction in the evaluation of the TAWSS is important, in particular in the combined use with OSI; the latter parameter already adequately described by other authors.

The concluding part appears, in particular with respect to the introductory part, decidedly more concise and in our opinion worthy of integration, in particular in terms of comparison with other studies with respect to which this may appear innovative and with added values. In this context, a reference to the more direct clinical applications in terms of possible use of the described application software should be considered.

Author Response

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Reviewer 2 Report

Good work on the paper. However, minor changes are needed before publishing.

Comments for author File: Comments.docx

Author Response

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Author Response File: Author Response.doc