Hertzer N R, Beven E G
Arch Surg. 1978 Jun;113(6):696-700. doi: 10.1001/archsurg.1978.01370180038004.
Between January 1974 and March 1977, arm bovine carotid heterograft arteriovenous fistulas were constructed in 75 patients. Twenty-six fistulas were established between the distal radial artery and an antecubital vein, and 49 fistulas used the brachial artery and the axillary vein. Thirty-eight heterografts have functioned without complication over a maximun interval of 29 months, including 15 of 26 radiobasilic fistulas and 23 of 49 brachioaxillary fistulas. Of the 37 heterograft failures, 28 were caused by thrombosis, six by infection, two by false aneurysm formation, and one by distal arm ischemia. Early postoperative thrombosis was associated with a higher subsequent failure rate after thrombectomy than was late thrombosis and it often required insertion of a new heterograft. Infected heterografts must be ligated and eventually replaced with another fistula at a distant site to avoid the potentially lethal complications of systemic sepsis and local hemorrhage.
1974年1月至1977年3月期间，为75例患者构建了带臂牛颈动脉异种移植动静脉内瘘。26例内瘘建立于桡动脉远端与肘前静脉之间，49例内瘘使用肱动脉和腋静脉。38个异种移植物已无并发症地发挥功能长达29个月，其中26例桡侧头静脉内瘘中有15例，49例肱腋内瘘中有23例。在37例异种移植物失败病例中，28例由血栓形成引起，6例由感染引起，2例由假性动脉瘤形成引起，1例由手臂远端缺血引起。术后早期血栓形成与血栓切除术后较高的后续失败率相关，高于晚期血栓形成，且通常需要植入新的异种移植物。感染的异种移植物必须结扎，并最终在远处部位用另一个内瘘替换，以避免全身败血症和局部出血等潜在致命并发症。
