Reconstruction of Small Arteries With an Arteriovenous Fistula

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Abstract
PROSTHETIC grafts have not been successful when used to reconstruct small arteries.1,2,3The inevitable clotting seems to be directly related to low flow rates through the graft resulting from the small capacity of the arterial bed that the graft supplies.4,5Flow through the reconstruction can be increased with a distal arteriovenous fistula. Dean and Read used a femoral arteriovenous fistula to prevent thrombosis in a proximal iliac graft in dogs.6However, this type of reconstruction may deprive the distal arterial bed of blood flow so that the tissue it supplies is compromised to preserve graft patency. Root and Cruz used an arteriovenous fistula in dogs to maintain patency of a distally ligated superficial femoral artery and concluded that this helped maintain viability of the limb.7 In the present experiment the value of arteriovenous fistulae in maintaining function of plastic grafts anastomosed to small arteries was studied.

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