The temporary arteriovenous fistula in venous reconstructive surgery.

The role of the temporary AV-fistula in venous reconstructive surgery is described. The objectives are: increase of blood flow in the proximal thrombectomised vein or in the venous graft; prevention of immediate re- or graft thrombosis; provide time for endothelial healing; promote development of collaterals in case of occlusion. The management of acute ilio-femoral venous thrombosis with thrombectomy and temporary AV-fistula is presented with results of 120 operations. No mortality due to fatal pulmonary embolism. In the prospective randomised study comparing surgery with conservative treatment follow-up demonstrated 76% patent iliac veins in operated group compared to 35% in the conservative group. Ten patients with iliac vein obstruction had immediate reconstruction with PTFE graft and AV-fistula. Three grafts are still functioning after 7, 15 and 56 months respectively.