February 1975

Venous Atherosclerosis Associated With Arteriovenous Fistulas for Hemodialysis

Author Affiliations

From the departments of pathology and surgery and the Specialized Center of Research on Arteriosclerosis of the Albany Medical College of Union University and the Veterans Hospital, Albany, NY.

Arch Surg. 1975;110(2):176-180. doi:10.1001/archsurg.1975.01360080042006

In two patients, venous loops fashioned into arteriovenous anastomoses for long-term hemodialysis developed gross irregularity and narrowing of the lumen. Histological and ultrastructural examination of the affected vein in one patient revealed atherosclerosis similar to that that develops in the anastomosed veins of experimental arteriovenous fistulas in sheep. The second patient, with angiographically similar changes in the venous loop, developed on aneurysm followed by thrombotic occlusion of the arteriovenous fistula. The development of venous atherosclerosis in these patients was analogous to that in the experimental animal, and was attributed to local hemodynamic stresses in the vein associated with the shunt.