Pike et al. (2019) investigated the effects of NOS3 and by extension eNOS overexpression in mice. Overexpression of eNOS was linked to increased lumen diameter and thus smoother blood flow and lower vorticity; on the other hand, it was also linked to wall thinning due to reduced WSS and inner wall circumferential stress, both of which resulted from larger lumen. Kudze et al. (2020), Bai et al. (2022), and Somarathna et al. (2020) all supported the key role of eNOS in successful AVF maturation and IH prevention. This evidence concerns the gene NOS3 and isolated hemihyperplasia.