Haemodynamics of the adjunctive arteriovenous fistula in femorodistal bypass grafting: An experimental study
✍ Scribed by Mr S. D. Parvin; S. Bentley; M. J. Asher; D. R. Prytherch; D. H. Evans; P. R. F. Bell
- Publisher
- John Wiley and Sons
- Year
- 1984
- Tongue
- English
- Weight
- 437 KB
- Volume
- 71
- Category
- Article
- ISSN
- 0007-1323
No coin nor oath required. For personal study only.
✦ Synopsis
The results of femorotibial bypass for limb salvage vary a great deal. One of the reasons for this might be the discrepancy between potential inflow and run-of into the foot. An arteriovenous fistula at the distal graft anastomosis may improve results but the best anatomical arrangement for the fistula is unknown. Ileofemoral grafts were performed in dogs after the hind limb was rendered ischaemic. The distal end of the graft was anastomosed proximal to, superimposed upon, or distal to an arteriovenous fistula between the femoral artery and its accompanying femoral vein. The efect of the fistula on grafthun-of haemodynamics was then measured. The adjunctive arteriovenous fistula increased injlow by a mean of 900 per cent and reduced systemic pressure by I0 per cent. Peripheral resistance was reduced by 85 per cent. Distal arterial run-of was maximized with respect to total graft jlow when the graft was placed distal to the fistula fp < 0.05). The venous steal ofjlow and perfusion pressure produced by the fistula was minimized with the same configuration compared to the two other arrangements (P < 0.01 and P < 0.05). Placement of the graft distal to the adjunctive arteriovenous fistula maximized distal arterial jlow and pressure, and signiJicantly increased graft $ow.