Repair of peripheral AV fistulas by intraluminal autogenous venous bypass grafting: An experimental study

Abstract

Artificial arteriovenous (AV) fistulas were created by performing side-to-side anastomosis between the femoral arteries and the femoral veins of 10 dogs. Intraluminal venous grafts were then used to repair these fistulas. Venous grafts were harvested from the contralateral lower limbs. In five of these cases the distal end of the grafts were fixed with arteriotomy sutures whereas in the remaining five they were not. All the vessels were evaluated by intraoperative angiography before and after the procedure. The dogs were reoperated on to remove the repaired arterial and venous segments for histopathological examination 3 weeks after the operation. Graft thrombosis was detected in two of the cases, in which the distal ends of grafts were not fixed. The repaired arterial and venous flows were normal in the remaining eight dogs. In conclusion, AV fistulas were successfully repaired in these dogs by intraluminal venous grafts, like the aneurysms repaired by the “elephant trunk” method, and the venous grafts were found to be histopathologically well organized with the surrounding arteries.