Adjuvant arteriovenous fistula as means of rescue for infrapopliteal venous bypass with poor runoff

Abstract

The adjuvant AV fistula increased graft flow significantly in a poor-outflow venous bypass. In this extreme patient group, acceptable patency and leg salvage was achieved without adverse effects. Despite this, the AV fistula did not improve the outcome.

Distal vein patch with an arteriovenous fistula: A viable option for the patient without autogenous conduit and severe distal occlusive disease

“…Although the fistula did not improve results, they did note that an adjunct fistula allowed patients with poor runoff to achieve comparable results for infrapopliteal bypass with superior runoff. 18 Graft flow was significantly higher in the fistula group.…”

The Use of Arteriovenous Fistulae as an Adjunct to Peripheral Arterial Bypass: A Systematic Review and Meta-analysis

“…Similarly, Laurila et al 18 identified no improvement in primary graft patency when an AVF was used in conjunction with a vein graft (RR ¼ 0.91, 95% CI 0.62e1.33).…”

“…Subgroup analysis again revealed no significant difference between groups when RCTs alone 19,20 (RR ¼ 0.97, 95% CI 0.66e1.44), studies comparing synthetic grafts [14,16,17,19,20] (pooled RR ¼ 1.45, 95% CI 0.86e2.46), or those contrasting vein grafts 18 were analysed (RR ¼ 0.95, 95% CI 0.69e1.31).…”

“…Seven studies 12,14,16,17,19,20 compared the use of AVF in conjunction with synthetic peripheral bypass with a control synthetic bypass group. These studies included two randomised and five retrospective cohort studies One cohort study by Laurila et al 18 assessed the merits of adjuvant AVF with peripheral vein bypass.…”

Free autovenous graft with destructed valves in treatment of severe ischemia of lower extremities

“…Длительность функцио-нирования синтетического и биологического проте-зов в бедренно-подколенной позиции в 2-2,5 раза меньше, чем аутовенозного трансплантата [1,12]. При неудовлетворительном состоянии путей оттока увеличения воспринимающего русла можно до-стичь путем наложения разгрузочной артериовеноз-ной фистулы, которая уменьшает сопротивление и тем самым способствует улучшению проходимости трансплантата [8,11]. Однако при этом резко сни-жается перфузия кровью ишемизированных тканей, что позволяет в большинстве наблюдений лишь уменьшить выраженность критической ишемии ко-нечностей, но не ликвидировать ее.…”