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February 22, 1965

Effects of an Arteriovenous Fistula on the Devascularized Limb

Author Affiliations

From the Department of Surgery, Ancker Hospital, St. Paul, and the University of Minnesota, Minneapolis.

JAMA. 1965;191(8):645-648. doi:10.1001/jama.1965.03080080035008

To reverse the tendency for thrombosis in small prosthetic grafts and sutured or otherwise damaged vessels, the advantages of maintaining a high rate of blood flow through these vessels by small caudad arteriovenous fistulae have been demonstrated previously in our laboratory. Neointimaformation was found in these damaged vessels. This principle could be used to maintain vessel patency until collateral flow could develop, particularly in patients with ischemic limbs in which standard femoropopliteal-artery reconstruction is unsuitable. The effects of arteriovenous fistulae have been said to be harmful. Four groups of dogs were used for study in order to avoid imposing further damage on ischemic limbs of patients. We sought thus to duplicate experimentally the clinical situation of obstructed or obliterated popliteal arteries.

Materials and Methods  Dogs of either sex weighing 25 to 35 lb were anesthetized with intravenous pentobarbital sodium. Through low midline abdominal and ventral thigh incisions, all branches of