From Particle Retention to Washout: Helical Bypass Geometry Reorganises Flow in Distal Anastomosis

Current evaluation of bypass graft performance relies predominantly on wall shear stress metrics, even though thrombosis and atherogenesis are fundamentally governed by particle transport and residence within disturbed flow regions. This disconnect limits the ability of conventional hemodynamic indicators to capture mechanisms directly linked to graft failure. In this study, we investigate how helical bypass geometry reorganises the flow and, consequently, modifies transport behaviour within the distal anastomosis by combining experimentally validated flow visualisation with computational fluid dynamics under pulsatile conditions. Particle transport was quantified using a controlled injection of 151 tracers, enabling direct assessment of retention and washout across the graft–anastomosis system. The straight configuration exhibited persistent recirculation structures that promoted localised particle retention and delayed clearance. In contrast, the helical geometry disrupted these structures, enhancing flow mixing and accelerating downstream transport. At late stages of the cardiac cycle, the helical configuration reduced residual particle retention by approximately 43% compared to the straight bypass. These findings demonstrate a transition from recirculation-driven retention to washout-dominated transport, providing a mechanistic basis for interpreting bypass performance beyond shear-based metrics. This transport-centred perspective provides a mechanistic link between flow organisation and particle residence, supporting the functional relevance of helical graft design while remaining distinct from direct modelling of biological thrombosis or atherogenesis.