Intermittent claudication of the hand after creation of an arteriovenous fistula in the forearm.
Eighty-five patients were followed up at least 1 year after creation of an arteriovenous fistula in the forearm. The anastomosis was side-to-side in 33 patients, end-to-side in 33 and end-to-end in 19. Trophic lesions were not observed. Intermittent claudication of the hand was more frequent in patients with a side-to-side arteriovenous fistula (42 percent) than in those with end-to-side (21 percent) or end-to-end fistulas (16 percent). Clinical and x-ray studies indicate that two different mechanisms are responsible for cramping pains: arterial steal phenomenon and venous hypertension. Their relative importance depends on multiple hemodynamic factors that may vary with time.
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged