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Arteriovenous fistula with a saphenous long loop
1Department of Surgery, Hospitalis da Universidade de Coimbra, Portugal.
Microsurgery
|January 1, 1993
Summary
Creating an arteriovenous fistula with a saphenous loop 10-21 days before free tissue transfer provides adequate vascularization. This technique simplifies vessel preparation and reduces operative time in complex reconstructions.
Area of Science:
- Vascular Surgery
- Microsurgery
- Tissue Transplantation
Background:
- Recipient vessels for free tissue transfer are often compromised after radiation, infection, or surgery.
- This necessitates the use of remote vessels and potentially long venous grafts, which are prone to compression in tissue tunnels.
Purpose of the Study:
- To evaluate the efficacy of a pre-created arteriovenous fistula using a saphenous loop for vascular access in free tissue transfer.
- To assess the feasibility and benefits of this technique in patients with challenging recipient vessel conditions.
Main Methods:
- An arteriovenous fistula was created using a long saphenous vein loop 10 to 21 days before the planned free tissue transfer.
- The saphenous loop was positioned near the reconstruction site, providing an artery and a vein upon division during transplantation.
Main Results:
- Adequate vascularization was achieved in 10 out of 12 cases.
- In 2 cases, suboptimal outcomes suggested a potential need for longer fistula maturation time.
- The procedure offered advantages including local anesthesia, easier patient positioning, and reduced operative time.
Conclusions:
- Pre-creating an arteriovenous fistula with a saphenous loop is a viable strategy for ensuring vascular supply in free tissue transfer.
- This method addresses challenges with recipient vessel identification and graft compression, offering a practical solution for complex reconstructive scenarios.