title: The impact of adjuvant av-fistula on cuffed Femorocrural PTFE bypass grafting: flow and pressure response.
abstract: OBJECTIVE
  The aim of the present study was to assess the effect of an adjuvant av-fistula on prosthetic bypass grafting and whether intraoperative flow measurements could predict patency and adverse events of cuffed femorocrural PTFE bypass with or without an av-fistula.
  
  
  METHODS
  A total of 50 patients in need of vascular reconstruction for critical limb ischaemia (CLI) but with no suitable venous conduit were included.
  
  
  RESULTS
  The flow values in patients with av-fistula were significantly higher (p=0.009) than in the group without the fistula but the higher flow values did not result in improved patency. The maximum flow velocity (Vmax) in the av-fistula group was significantly higher in the immediate postoperative period (p=0.04), but there was no difference in patency. When a flow value of 50 ml/min was used as a cut-off point, patients with a higher flow had significantly better immediate patency (p=0.025).
  
  
  CONCLUSIONS
  The adjuvant av-fistula neither caused any adverse effects nor had any effect on patency.
authors.affiliation: Department of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, FIN-00029 HUS, Helsinki, Finland. katariina.laurila@hus.fi
authors.forename: K
authors.initials: K
authors.lastname: Laurila
authors.forename: P S
authors.initials: PS
authors.lastname: Aho
authors.forename: A
authors.initials: A
authors.lastname: Albäck
authors.forename: K
authors.initials: K
authors.lastname: Teittinen
authors.forename: I
authors.initials: I
authors.lastname: Kantonen
authors.forename: M
authors.initials: M
authors.lastname: Lepäntalo
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D016009:Chi-Square Distribution; D005263:Femoral Artery / Q000601:surgery; D005387:Finland; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014463:Ultrasonography
chemical_list: D011138:Polytetrafluoroethylene