Questionable value of adjuvant arteriovenous fistula in pedal bypass at high risk for early failure.

Questionable value of adjuvant arteriovenous fistula in pedal bypass at high risk for early failure. Research Abstract Details 

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Questionable value of adjuvant arteriovenous fistula in pedal bypass at high risk for early failure. Abstract Text:

Results of an adjuvant arteriovenous fistula (AVF) in pedal bypass surgery in the presence of poor status of the recipient artery, severely impaired intraoperative runoff, or revision for early failure and flow restitution were analyzed in a retrospective study. From January 1998 to December 2006, 24 adjuvant AVFs were constructed in autologous vein or composite pedal bypasses with low intraoperative bypass flow, poor status of the pedal artery, or during successful early bypass revision to prevent graft failure. All infrainguinal bypass operations were registered in a computerized database and prospectively followed. Pedal bypasses with adjunctive AVF were reviewed for fistula function, graft patency, limb salvage, and patient survival. Primary and secondary bypass patency rates at 1 year were 59% and 77%, respectively, with an AVF patency of 36%. Four legs were amputated despite a patent bypass with patent AVF on three occasions. The corresponding limb salvage rate was 65% at 1 year. Patient survival was 50% at 3 years. Adjuvant AVF constructed in grafts considered at high risk for early failure in pedal vein graft or composite bypass does not seem to prevent future graft failure. In patent bypasses the fistula has a significant tendency for spontaneous occlusion. It may be considered in the use of prosthetic composite pedal grafts in selected cases.

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PUBMED ID PMID:

MEDLINE DATE: 2008 May-Jun

Questionable value of adjuvant arteriovenous fistula in pedal bypass at high risk for early failure. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Annals of vascular surgery

VOLUME: 22

Page Numbers: 379-87

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ISSN: 1615-5947

DAY: 24

MONTH: 03

YEAR: 2008

Questionable value of adjuvant arteriovenous fistula in pedal bypass at high risk for early failure. Information

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LANGUAGE: eng

NlmUniqueID: 8703941

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AFFILIATION: Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg-University School of Medicine, Mainz, Germany.

Country: United States

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MEDLINETA: Ann Vasc Surg

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