A clinical method for the detection of arteriovenous fistulas during in situ great saphenous vein bypass.
Residual arteriovenous fistulas are a potential source of morbidity after femorodistal bypass operation has been performed with the in situ great saphenous vein graft. A review of our initial experience with 155 operations in which various methods of intraoperative detection were used showed that fistulas were overlooked in 27 cases (17.4%), causing graft thrombosis in 10 cases (6.4%). After the introduction of a rapid and simple intraoperative test that used retrograde irrigation of the graft, only three superficial fistulas were overlooked in 70 operations (4.2%), with no associated graft thrombosis. The test had no detectable deleterious effects and graft distension pressures were within acceptable limits.
D000792:Angiography; D001164:Arteriovenous Fistula / Q000175:diagnosis*; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D010173:Palpation; D011183:Postoperative Complications / Q000209:etiology; D012212:Rheology; D012501:Saphenous Vein / Q000637:transplantation*; D007507:Therapeutic Irrigation; D013927:Thrombosis / Q000209:etiology