| Anastomotic arteriovenous fistulae--are they worth it? | |
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MedLine Citation:
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PMID: 3169275 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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An adjuvant distal arteriovenous fistula (ADAVF) has been claimed to increase arterial bypass graft flow and patency when run-off is poor but others have suggested that a patent fistula does not improve in distal limb perfusion. In 10 dogs, hind limbs were rendered ischaemic by proximal arterial ligations and then revascularised with vein grafts. In each dog an ADAVF was constructed on the left graft while the right was used as a control. Flow and pressure were measured in each graft and distal artery and the effect of temporary occlusion and release of the fistula noted. These measurements were repeated at re-operation 3 months later. Mean flow through control grafts was 83 +/- 8.57 (S.E.M.) ml/min, increasing to 146 +/- 22.89 (S.E.M.) ml/min with papaverine (P less than 0.001, Student's t test), and was unchanged at 3 months. Mean flow in grafts with a distal A-V fistula was 250 +/- 41.68 (S.E.M.) ml/min with no change after papaverine, and an increase to 730 +/- 110.5 (S.E.M.) ml/min at 3 months (P less than 0.001, Student's t test). However, arterial flow distal to the fistula was invariably retrograde at initial operation (20 +/- 3.0 S.E.M. ml/min), and this retrograde flow increased to 180 +/- 33.2 (S.E.M.) ml/min at 3 months (P less than 0.001, Student's t test). Distal arterial pressure at initial operation fell from 88.8 +/- 3.35 (S.E.M.) mmHg to 10.8 +/- 1.01 (S.E.M.) mmHg with the fistula open. We conclude that in this animal model an adjuvant distal arteriovenous fistula may improve bypass graft flow, but is unlikely to benefit distal limb perfusion. |
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Authors:
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B R Gwynn; C P Shearman; M H Simms |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of vascular surgery Volume: 2 ISSN: 0950-821X ISO Abbreviation: Eur J Vasc Surg Publication Date: 1988 Apr |
Date Detail:
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Created Date: 1988-11-18 Completed Date: 1988-11-18 Revised Date: 2003-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8709440 Medline TA: Eur J Vasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 71-6 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, Selly Oak Hospital, Birmingham, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Arteriovenous Shunt, Surgical* Blood Vessel Prosthesis* Dogs Female Femoral Artery / surgery Femoral Vein / surgery Hindlimb / blood supply Ischemia / surgery* Regional Blood Flow Vascular Patency |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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