The impact of adjuvant av-fistula on cuffed Femorocrural PTFE bypass grafting: flow and pressure response.

Abstract

The aim of the present study was to assess the effect of an adjuvant av-fistula on prosthetic bypass grafting and whether intraoperative flow measurements could predict patency and adverse events of cuffed femorocrural PTFE bypass with or without an av-fistula. A total of 50 patients in need of vascular reconstruction for critical limb ischaemia (CLI) but with no suitable venous conduit were included. The flow values in patients with av-fistula were significantly higher (p=0.009) than in the group without the fistula but the higher flow values did not result in improved patency. The maximum flow velocity (Vmax) in the av-fistula group was significantly higher in the immediate postoperative period (p=0.04), but there was no difference in patency. When a flow value of 50 ml/min was used as a cut-off point, patients with a higher flow had significantly better immediate patency (p=0.025). The adjuvant av-fistula neither caused any adverse effects nor had any effect on patency.