Primary 1-year access patency rates after CVT compare favorably with those after interventional treatment, and reintervention rates are lower. Frequently occurring prestenotic aneurysms could be repaired simultaneously. CVT should therefore be regarded as the treatment of choice for CAS.

A non-stress test, an ultrasound biometry (biparietal and abdominal diameter) and a Doppler sonography blood flow measurement (fetal descending aorta, umbilical artery and fetal middle cerebral artery) were performed in the third trimester of 130 multiple pregnancies. These three methods were compared in terms of their prognostic value for fetal growth retardation (81 from 263 children; defined as weight at birth < 10 percentile) and a pathological "fetal outcome" (76 from 263 children, defined as 5-min-Apgar < 8, umbilical artery-pH < 7.20 and transfer to neonatal intensive care unit). Fetal growth retardation could best be predicted by means of the Doppler results for all three blood vessels ("total Doppler result") (sensitivity of 75.9%). Doppler results for all three blood vessels showed the best result in predicting a pathological "fetal outcome"; the sensitivity was 60.3%. The biometric examinations with ultrasound and the non-stress test produced worse results compared to Doppler sonography. Doppler velocimetry of only one blood vessel showed worse results compared to Doppler velocimetry of more than one blood vessel. Doppler sonography should be performed as a routine test for all multiple pregnancies. More intensive pregnancy surveillance is urgently recommended with pathological findings.

Autologous surgical reconstruction is feasible in the majority of AVF aneurysms. It preserves fistula function and--in contrast to graft interposition and endovascular repair--keeps the advantages of an autogenous access: low complication and high patency rates.

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