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

Aherne, Thomas; Kheirelseid, Elrasheid; O’Neill, Darragh; Bashar, Khalid; Cullen, Patricia; Whitford, David L; Naughton, Peter

doi:10.1016/j.ejvs.2016.01.014

Cited by 9 publications

(5 citation statements)

References 34 publications

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“…( 2016) описаны 966 пациентов с указанием на то, что хотя и артериовенозная фистула и не связана с дополнительными операционными осложнениями, существует мало доказательств эффективности ее использования. Выводы об оценке ее преимуществ малоубедительны по причине небольших ретроспективных исследований с участием разнородных когорт [18].…”

Section: Discussionunclassified

Results of the tibioperoneal trunk repair in patients with advanced atherosclerosis

Krepkogorskiy

Bredikhin

2023

Innovacionnaâ medicina Kubani

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Objective: To study immediate and long-term results of the tibioperoneal trunk repair (plastic reconstruction or prosthetic repair) during femoropopliteal bypass.Materials and methods: In our retrospective cohort study we analyzed surgical treatment results of 109 patients with lower extremities atherosclerosis who were treated in the Vascular Surgery Unit of Interregional Clinical Diagnostic Center (Kazan, Russian Federation) from 2018 to 2020. 26 (23.8%) patients were hospitalized for stage IB-IIA acute arterial insufficiency with atherothrombosis, and 83 (76.1%) patients were admitted with critical limb ischemia (CLI) as a result of advanced atherosclerosis. Among the CLI patients, 43 (39.4%) of them had stage III chronic arterial insufficiency, and 40 (36.7%) patients had stage IV chronic arterial insufficiency. The study selection criteria included extensive femoral and popliteal arteries disease and significant stenosis or occlusion of the tibioperoneal trunk. TASC II type C lesions were detected in 2 (1.8%) patients, while 107 (98.2%) patients were diagnosed with TASC II type D lesions. Based on the GLASS classification, all 109 (100%) patients had FP grade 3-4 femoropopliteal lesions with concomitant IP grade 1-4 tibial lesion. The main group included 24 (22%) patients who underwent femoropopliteal bypass with plastic or prosthetic repair of the tibioperoneal trunk using an original technique. The control group included 85 (78%) patients who underwent bypass surgery without the tibioperoneal trunk repair. Isolated femorotibial bypass was performed in 7 (8.2%) patients, and 78 (91.7%) patients underwent femoropopliteal bypass with a reversed autogenous vein.Results: We followed up patients for 2 years after surgery. Immediate technical success was 97.24% (106/109). Graft thrombosis was reported in 3 cases. No difference between the groups was observed. Long-term graft patency was significantly higher in the main group (P = .044) and significantly associated with age (RR = 0.96; 95% CI of 0.92 to 1.00, P = .03), type 2 diabetes mellitus (RR = 2.10; 95% CI of 1.10 to 4.10, P = .03), and history of the tibioperoneal trunk repair (RR = 0.43; 95% CI of 0.18 to 1.00, P = .06). Variables associated with patency in the univariate regression at a significance level P ≤ .1 were included in a multivariate model that demonstrated the combined effect of predictors on the outcome.Conclusions: Femoropopliteal bypass with the tibioperoneal trunk repair improves treatment results in patients with extensive peripheral artery disease and immediately threatened limbs or a threat to a limb within 2 years.

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Section: Discussionunclassified

Results of the tibioperoneal trunk repair in patients with advanced atherosclerosis

Krepkogorskiy

Bredikhin

2023

Innovacionnaâ medicina Kubani

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“…According to a systematic review from 2016, however, the use of an arteriovenous fistula does not improve limb salvage after vein bypass surgery. 13 another is, therefore, not possible. Most often the venous system is without obstructions and animal experimental studies 14 suggest that oxygen and nutrients may reach the capillary bed and, hence the tissue, from the venous side.…”

Section: Bypass To Pedal Arteriesmentioning

confidence: 99%

“…The extra run off through the venous system reduces afterload and increases flow through the bypass which should increase graft patency although at the theoretical expense of a ‘steal’ phenomenon, directing most of the flow away from the ischemic target. According to a systematic review from 2016, however, the use of an arteriovenous fistula does not improve limb salvage after vein bypass surgery …”

Section: Av‐fistulamentioning

confidence: 99%

Surgical revascularization and reconstruction procedures in diabetic foot ulceration

Houlind

2019

Diabetes Metabolism Res

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This article summarizes surgical procedures for preservation of the foot in diabetic patients with peripheral artery disease. Distal bypass surgery performed to perigeniculate arteries and to an isolated ‘blind’ popliteal segment with visible collaterals can be performed with limb salvage rates close to what can be achieved with standard bypass to crural arteries. This is also the case when performing bypass to the dorsalis pedis artery. Bypass to the medial or lateral plantar artery or to the lateral tarsal artery is associated with a relatively high rate of early occlusion, but in the patients who have persistently open grafts, limb salvage is common. The use of an arteriovenous fistula as an adjunct to distal bypass surgery does not improve prognosis. Venous arterialization, either creating retrograde perfusion of the superficial or of the deep veins of the foot has been successful in several cases although it is difficult to predict which patients will benefit. Reconstructive surgery is often performed in a multidisciplinary team including plastic surgeons. In patients with need of more extensive cover of defects, the transplant of muscular or fasciocutaneous free flaps has provided good results in the few centres that have applied this technique. This procedure can be combined with a revascularization in the same session or at a later stage. A majority of the described techniques can be implemented in most vascular centres and they should be considered in complicated cases when standard methods of revascularization and reconstruction do not suffice.

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“…This has the ability to modulate blood flow into AVAs. 40 Histologically, AVAs are distinguished by muscular walls and irregular lumina (three to eight times bigger than those of capillaries). A less than 90 mmHg pressure during diastole, leading AVA to open.…”

Section: Effects Of Antihypertensive Drugs On Arteriovenous Anastomosismentioning

confidence: 99%

Photoplethysmography for Assessing Microcirculation in Hypertensive Patients After Taking Antihypertensive Drugs: A Review

Hu,

Song

2024

JMDH

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High blood pressure (BP) is a common disease and is associated with many chronic diseases. Measuring BP is essential for the treatment and management of many diseases, and therefore there is a growing need for a non-invasive, sleeveless and continuous BP monitoring device. With the development of technology, pulse waveform analysis using photoplethysmography (PPG) has become more feasible for evaluating BP. This study aimed to evaluate the changes of vascular elasticity and blood volume over time by using the characteristic parameters extracted by PPG. We reviewed the latest progress and literature on the observation of capillary network characteristics in hypertensive and non-hypertensive patients by PPG, the influence of different drugs on microcirculation characteristics in hypertensive patients with PPG, and further explored the key relationship between microcirculation and hypertension. We found that the PPG waveform produced by the fingertips of hypertensive patients is very different from that of healthy people, and the PPG waveform changes significantly during diastolic period after antihypertensive treatment. With the rapid development of medical technology, people can get more intuitive microcirculation image data, which provides beneficial help for the comprehensive understanding of hypertension.

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

Abstract: Although adjuvant AVF is not associated with additional operative complication there is little evidence to support its use. The evidence assessing its merits is weakened by small, retrospective studies with heterogeneous cohorts.

Cited by 9 publications

References 34 publications

Results of the tibioperoneal trunk repair in patients with advanced atherosclerosis

Results of the tibioperoneal trunk repair in patients with advanced atherosclerosis

Surgical revascularization and reconstruction procedures in diabetic foot ulceration

Photoplethysmography for Assessing Microcirculation in Hypertensive Patients After Taking Antihypertensive Drugs: A Review

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