The temporary arteriovenous fistula in venous reconstructive surgery.
The role of the temporary AV-fistula in venous reconstructive surgery is described. The objectives are: increase of blood flow in the proximal thrombectomised vein or in the venous graft; prevention of immediate re- or graft thrombosis; provide time for endothelial healing; promote development of collaterals in case of occlusion. The management of acute ilio-femoral venous thrombosis with thrombectomy and temporary AV-fistula is presented with results of 120 operations. No mortality due to fatal pulmonary embolism. In the prospective randomised study comparing surgery with conservative treatment follow-up demonstrated 76% patent iliac veins in operated group compared to 35% in the conservative group. Ten patients with iliac vein obstruction had immediate reconstruction with PTFE graft and AV-fistula. Three grafts are still functioning after 7, 15 and 56 months respectively.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001166:Arteriovenous Shunt, Surgical; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006083:Graft Occlusion, Vascular; D006439:Hemodynamics; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007084:Iliac Vein / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011446:Prospective Studies; D011897:Random Allocation; D013924:Thrombophlebitis / Q000188:drug therapy / Q000601:surgery*; D013997:Time Factors; D014690:Venous Pressure
D006493:Heparin