Arteriovenous fistula as adjuvant treatment in arterial revascularization of an at-risk limb.
| Autor: | Giusti JCG; Hospital Municipal do Tatuapé Dr. Carmino Caricchio (HMCC), São Paulo, SP, Brasil., Tartarotti SP; Hospital Municipal do Tatuapé Dr. Carmino Caricchio (HMCC), São Paulo, SP, Brasil., Rossi FH; Instituto Dante Pazzanese de Cardiologia (IDPC), São Paulo, SP, Brasil., Beraldo JPN; Hospital Municipal do Tatuapé Dr. Carmino Caricchio (HMCC), São Paulo, SP, Brasil., Brochado FC; Hospital Municipal do Tatuapé Dr. Carmino Caricchio (HMCC), São Paulo, SP, Brasil. |
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| Jazyk: | angličtina |
| Zdroj: | Jornal vascular brasileiro [J Vasc Bras] 2021 Sep 10; Vol. 20, pp. e20210042. Date of Electronic Publication: 2021 Sep 10 (Print Publication: 2021). |
| DOI: | 10.1590/1677-5449.210042 |
| Abstrakt: | Acute arterial occlusion remains a major challenge for the vascular surgeon. The therapeutic approach depends mostly upon the severity of the tissue injury and the duration of symptoms. Several techniques are available in the current therapeutic arsenal, however, regardless of the technique chosen, postoperative factors frequently observed, such as poor outflow status, or even low graft flow, can contribute negatively to the outcome of revascularization. We describe a case of acute limb ischemia, in the postoperative period of a femoral-tibial bypass, which was occluded due to outflow limitation and high peripheral vascular resistance. The patient underwent a second tibial revascularization combined with construction of an arteriovenous fistula, followed by forefoot amputation and partial skin graft. An energetic approach to the at-risk limb makes it possible to reduce unfavorable outcomes, such as amputation and death, and accelerates recovery of tissues affected by acute ischemia. Competing Interests: Conflicts of interest: No conflicts of interest declared concerning the publication of this article. (Copyright© 2021 The authors.) |
| Databáze: | MEDLINE |
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