Impact of side-hole geometry on the performance of hemodialysis catheter tips: A computational fluid dynamics assessment

David G. Owen*, Diana C. de Oliveira, Shuang Qian, Naomi C. Green, Duncan E.T. Shepherd, Daniel M. Espino

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
175 Downloads (Pure)


Hemodialysis catheters are used to support blood filtration, yet there are multiple fundamentally different approaches to catheter tip design with no clear optimal solution. Side-holes have been shown to increase flow rates and decrease recirculation but have been associated with clotting/increased infection rates. This study investigates the impact of changing the shape, size and number of side-holes on a simple symmetric tip catheter by evaluating the velocity, shear stress and shear rate of inflowing blood. A platelet model is used to examine the residence time and shear history of inflowing platelets. The results show that side-holes improve the theoretical performance of the catheters, reducing the maximum velocity and shear stress occurring at the tip compared to non-side-hole catheters. Increasing the side-hole area improved performance up to a point, past which not all inflow through the hole was captured, and instead a small fraction slowly 'washed-out' through the remainder of the tip resulting in greater residence times and increasing the likelihood of platelet adhesion. An oval shaped hole presents a lower chance of external fibrin formation compared to a circular hole, although this would also be influenced by the catheter material surface topology which is dependent on the manufacturing process. Overall, whilst side-holes may be associated with increased clotting and infection, this can be reduced when side-hole geometry is correctly implemented though; a sufficient area for body diameter (minimising residence time) and utilising angle-cut, oval shaped holes (reducing shear stress and chances of fibrin formation partially occluding holes).

Original languageEnglish
Article numbere0236946
JournalPLoS ONE
Issue number8
Publication statusPublished - 7 Aug 2020


  • Blood Flow Velocity
  • Blood Platelets/cytology
  • Catheters/statistics & numerical data
  • Computational Biology
  • Computer Simulation
  • Equipment Design
  • Hemodynamics
  • Humans
  • Hydrodynamics
  • Models, Cardiovascular
  • Platelet Adhesiveness
  • Renal Dialysis/instrumentation


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