Hemodynamic Effects of Femoral Venous Occlusion Before and After an Acute Arteriovenous Fistula

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Abstract
Cardiac output, femoral artery blood flows, and arterial and venous pressure measurements were studied in mongrel dogs before and after the construction of femoral arteriovenous fistulas. Values were also obtained on venous occlusion of the femoral vein and proximal venous fistula limb. The t-test for small samples was used to determine the significance of all changes. Femoral vein occlusion in the pre-fistula animal caused a decrease in cardiac output and femoral artery flow. This finding supports the need for venotomy and aspiration of clots in selected cases of peripheral arterial embolization and obstructed venous circulation. In the post-fistula animal, proximal venous limb occlusion reduced cardiac output and femoral artery flow but did not return flows to pre-fistula normal values. The venous pressure was found to approximate arterial levels in the distal venous network. These findings are discussed in relation to mesenteric arteriovenous shunts and the condition of portal hypertension with esophageal and gastric varices.