Sawchuk A P, Dalsing M C, Emerick S C, Waller B F, Reilly M K, Broadie T A
Surgery. 1987 Aug;102(2):256-62.
The formation of a temporary distal arteriovenous fistula (dAVF) has been used clinically to palliate patients with symptomatic venous hypertension. This study tested the efficacy of a temporary dAVF for the treatment of venous hypertension in an experimental model. Twenty-four New Zealand white rabbits were divided into two experimental groups. Group I rabbits (n = 12) underwent standardized ligation of the iliac and femoral venous systems. Group II rabbits (n = 12) underwent standardized ligation of the iliac and femoral venous systems with the formation of a temporary dAVF. Venous obstruction was documented with venography, and venous hypertension was documented with femoral venous pressure measurements. Venous pressure, resistance, blood flow, vein circumference, vein cross-sectional area, vein wall thickness, and venography were compared between four rabbits from each group at 2, 4, and 8 weeks. The effect of differences in baseline venous pressures was eliminated by subtracting the venous pressure in the unobstructed rabbit limb from the pressure in the obstructed rabbit leg. Group II rabbits had a lower standardized venous pressure (4.4 +/- 2.2 versus 9.5 +/- 4.2 mm Hg, p less than 0.01) and venous outflow resistance (0.16 +/- 0.08 versus 0.36 +/- 0.18, p less than 0.05) than did group I rabbits. Group II rabbits also had a larger superficial femoral vein circumference (3.46 +/- 0.67 versus 2.57 +/- 0.08 mm, p less than 0.05) and cross-sectional area (0.66 +/- 0.31 versus 0.31 +/- 0.09 mm2, p less than 0.01) than did group I rabbits. The improvement persisted throughout the 6-week study, which suggested an improved venous outflow.
临时性动静脉内瘘（dAVF）的建立已在临床上用于缓解有症状性静脉高压的患者。本研究在一个实验模型中测试了临时性dAVF治疗静脉高压的疗效。24只新西兰白兔被分为两个实验组。第一组兔子（n = 12）接受髂静脉和股静脉系统的标准化结扎。第二组兔子（n = 12）接受髂静脉和股静脉系统的标准化结扎并建立临时性dAVF。通过静脉造影记录静脉阻塞情况，通过测量股静脉压力记录静脉高压情况。在每组的4只兔子中，于2周、4周和8周时比较静脉压力、阻力、血流量、静脉周长、静脉横截面积、静脉壁厚度和静脉造影结果。通过用未阻塞兔肢体的静脉压力减去阻塞兔腿的压力，消除了基线静脉压力差异的影响。与第一组兔子相比，第二组兔子的标准化静脉压力较低（4.4±2.2对9.5±4.2 mmHg，p<0.01），静脉流出阻力也较低（0.16±0.08对0.36±0.18，p<0.05）。第二组兔子的股浅静脉周长（3.46±0.67对2.57±0.08 mm，p<0.05）和横截面积（0.66±0.31对0.31±0.09 mm2，p<0.01）也比第一组兔子大。这种改善在整个6周的研究中持续存在，提示静脉流出得到改善。
