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September 1966

Experimental Venous Replacement With a Temporary Arteriovenous Fistula

Author Affiliations

From the Department of Surgery, Hahnemann Medical College, Philadelphia. Dr. Mitsuoka is a Fulbright Fellow from the Department of Thoracic and Cardiovascular Surgery, Sapporo Medical College and Hospital, Japan.

Arch Surg. 1966;93(3):382-387. doi:10.1001/archsurg.1966.01330030012003

NUMEROUS studies of grafts in the venous system performed in this1,2 and other laboratories over the past six years have resulted in generally unsatisfactory results with prostheses and venous homografts. Autografts have given better results. The graft failure has usually resulted from early intraluminal thrombosis or from late stenosis at the suture line.

Since 1960, Moore and associates3 and others4-6 have reported fairly successful superior vena cava grafting using Teflon prostheses which they have considered to be the most reliable prostheses for this purpose. In one of the more extensive studies, Wada and Ogasawara7 demonstrated the limitations of the various prostheses. In this laboratory the results with Teflon have not been sufficiently reliable to permit clinical evaluation.

Pilot studies by Bryant et al8 in 1958 suggested that an arteriovenous fistula tended to permit venous grafts to remain patent. Recently, using the temporary arteriovenous shunt

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