Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
J Ultrasound Med. 2022 Jan;41(1):207-216. doi: 10.1002/jum.15696. Epub 2021 Mar 15.
To analyze and classify arterial supply and venous drainage of postcatheterization femoral arteriovenous fistulas (AVFs).
A review of extremity Doppler reports identified 77 femoral AVFs in 75 patients. Doppler exams were reviewed retrospectively. Fistulas were classified as above or below the common femoral artery bifurcation and subclassified based on the location of arterial inflow and venous outflow.
Arterial inflow originated above the femoral bifurcation in 32 cases. The communication was between the common femoral artery and the superficial circumflex iliac vein in 25 of 32 cases and between a branch of the common femoral or external iliac artery and the common femoral or external iliac vein in 4 of 32 cases. In 3 of 32 cases, AVFs arose from the common femoral artery, but the venous outflow was not determined. Arterial inflow originated from the superficial femoral artery in 23 cases. Venous outflow originated from the common femoral vein in 10 of 23 cases, the femoral vein in 7 of 23 cases, and the lateral circumflex femoral vein in 6 of 23 cases. Arterial inflow originated from the deep femoral artery in 12 cases. Venous outflow originated from the common femoral vein in 6 of 12 cases and from the lateral circumflex femoral vein 6 of 12 cases. In 8 cases, the AVF originated below the bifurcation, but the arterial inflow was not classified. In 2 cases, it was impossible to determine if the AVF originated above or below the bifurcation.
Iatrogenic femoral AVFs arise above the femoral bifurcation more often than previously recognized. Classification based on the arterial inflow and venous outflow provides a straightforward means of describing these fistulas.
分析和分类经导管股动静脉瘘（AVF）的动脉供血和静脉引流。
回顾性分析肢体多普勒报告，确定了 75 例 77 例股 AVF。回顾性审查多普勒检查。根据动脉流入和静脉流出的位置，将瘘管分为股动脉分叉以上和以下，并进行分类。
动脉流入起源于 32 例股动脉分叉以上。25 例与股总动脉和旋髂浅静脉相通，32 例中的 4 例与股总或外动脉分支和股总或外静脉相通。在 32 例中，3 例 AVF 起源于股总动脉，但静脉流出未确定。动脉流入起源于 23 例股浅动脉。静脉流出起源于 10 例股总静脉、7 例股静脉和 6 例旋股外侧静脉。12 例动脉流入起源于股深动脉。静脉流出起源于 6 例股总静脉和 6 例旋股外侧静脉。8 例瘘管起源于分叉以下，但动脉流入未分类。2 例无法确定瘘管起源于分叉以上或以下。
医源性股 AVF 比以前认识的更常发生在股动脉分叉以上。基于动脉流入和静脉流出的分类为描述这些瘘管提供了一种简单的方法。
