Hemodynamic sequelae of combined arteriovenous injury in an experimental canine hindlimb model: venous ligation vs. repair.
The hemodynamic effects of combined venoarterial injury and stasis were studied in the hindlimbs of 10 dogs. Femoral arterial blood flow and pressure, peripheral venous pressure, and peripheral resistance were measured after the restoration of blood flow following venoarterial injury and a 4-hour period of occlusion for up to 72 hours. In one limb of each animal both the artery and vein were repaired, whereas only the artery was repaired in the other limb and the vein was ligated. Arterial blood flow was similar in both groups but was significantly diminished from baseline for the first 30 minutes after restoration of blood flow, but then it became significantly reduced in the limbs with venous ligation when compared with values in those with venous repair. By 72 hours the flow on both sides returned to control values. Peripheral venous hypertension and edema occurred in all 10 limbs with venous ligation and persisted for the 72-hour experimental period. In the 10 limbs with venous repair, edema occurred in four and venous hypertension in none. The peripheral resistance was elevated on both sides; this elevation persisted for 75 minutes and then dropped to control values. None of the repaired arteries and only one repaired vein thrombosed during the experiment. Combined venous and arterial occlusion for 4 hours reduced both the amount of arterial flow and its subsequent rate of increase compared with changes seen after release of an acute venous occlusion. The rate of increase was enhanced by repair of the affected venous segment compared with simple venous ligation.
Nazzal
M
M
Department of Surgery, William Beaumont Hospital, Royal Oak, Mich. 48073-6769.
Bove
P G
PG
Harris
J A
JA
Bendick
P J
PJ
Glover
J L
JL
D000818:Animals; D001810:Blood Volume; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D005263:Femoral Artery / Q000293:injuries / Q000502:physiology* / Q000601:surgery; D005268:Femoral Vein / Q000293:injuries / Q000502:physiology / Q000601:surgery*; D006439:Hemodynamics; D006614:Hindlimb / Q000098:blood supply; D008026:Ligation; D008297:Male; D012039:Regional Blood Flow; D014690:Venous Pressure