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Arteriovenous Fistula in Arterial Reconstruction of the Ischemic Limb
David B. Hinshaw, MD;
Carlos A. Schmidt, MD;
Daniel B. Hinshaw, MD;
James B. Simpson, MD
Arch Surg. 1983;118(5):589-592.
Abstract
• The high flow associated with an arteriovenous fistula has been shown to help maintain patency in small arterial anastomoses. In 37 male patients we created common ostium arterlovenous fistula at the distal tibial or peroneal anastomosis as a part of their arterial reconstruction for threatened limb loss. Limb salvage was achieved in 28. Successful amputations at a lower level than would have been anticipated were performed in three. There was early graft failure in four patients resulting in below-the-knee amputations. This operative approach may be helpful in patients who have had previous revascularization procedures that have failed, who resist the Idea of amputation, and who fulfill the angiographic criteria of extremely poor runoff with an absent or deficient pedal arch.
(Arch Surg 1983;118:589-592)
Author Affiliations
From the Surgical Service, Jerry L. Pettis Memorial Veterans Administration Hospital, Loma Linda, Calif, and the Department of Surgery, Loma Linda University School of Medicine.
Footnotes
Accepted for publication Jan 3, 1983.
Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 16, 1982.
Reprint requests to Surgical Service, Jerry L. Pettis Memorial Veterans Administration Hospital, Loma Linda, CA 92357 (Dr David Hinshaw).
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