Intermittent claudication of the hand after creation of an arteriovenous fistula in the forearm

Am J Surg. 1980 Jun;139(6):838-43. doi: 10.1016/0002-9610(80)90393-1.

Abstract

Eighty-five patients were followed up at least 1 year after creation of an arteriovenous fistula in the forearm. The anastomosis was side-to-side in 33 patients, end-to-side in 33 and end-to-end in 19. Trophic lesions were not observed. Intermittent claudication of the hand was more frequent in patients with a side-to-side arteriovenous fistula (42 percent) than in those with end-to-side (21 percent) or end-to-end fistulas (16 percent). Clinical and x-ray studies indicate that two different mechanisms are responsible for cramping pains: arterial steal phenomenon and venous hypertension. Their relative importance depends on multiple hemodynamic factors that may vary with time.

MeSH terms

  • Adolescent
  • Adult
  • Angiography
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Arteriovenous Shunt, Surgical / methods
  • Female
  • Follow-Up Studies
  • Hand / blood supply*
  • Humans
  • Intermittent Claudication / diagnostic imaging
  • Intermittent Claudication / etiology*
  • Male
  • Middle Aged