Does an Adjuvant AV-fistula Improve the Patency of a Femorocrural PTFE bypass with Distal Vein Cuff in Critical Leg Ischaemia?—A Prospective Randomised Multicentre Trial

Abstract

Adjuvant AV-fistula does not improve the patency of a femorocrural PTFE bypass with a distal vein cuff.

Polyester vascular patches acquire arterial or venous identity depending on their environment

“…). These results provide rationale for the clinical use of AVF with polyester venous reconstruction, despite the ongoing clinical controversy regarding the effects of distal AVF on long‐term lower extremity prosthetic arterial graft patency …”

“…These results provide rationale for the clinical use of AVF with polyester venous reconstruction, despite the ongoing clinical controversy regarding the effects of distal AVF on long-term lower extremity prosthetic arterial graft patency. [64][65][66][67][68][69][70] Although vascular cell identity is genetically predetermined and present in the embryo, the arterial or venous microenvironment can also play a role in determining endothelial cell identity 21,71 ; however it is not established whether vessel identity is plastic in adult cells or whether plasticity is restricted to embryonic, stem cell, and neoplastic environments. [72][73][74][75] We show that the neointima that forms in adult rats acquires arterial identity in the aorta and venous identity in the IVC (Fig.…”

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

“…14 Although construction of an AVF does increase graft flow, it has been difficult to demonstrate that this leads to improvement in graft patency. 15 Adding an AVF to the DVP configuration may decrease outflow resistance and improve graft hemodynamics. Although this does not directly correlate with a reduction in the formation of intimal hyperplasia, it may improve graft performance from a hemodynamic approach.…”

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

“…At this point, nine papers were excluded from the analysis 24e32 as eight were non-comparative 24e29,31e33 and one was a review article. 30 Included studies consisted of two randomised controlled trials 19,20 and seven retrospective cohort studies. 11,12,14e18…”

“…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.…”