TITLE

A CLINICO-PATHOLOGIC STUDY OF MULTIPLE CONGENITAL ARTERIOVENOUS FISTULAS OF THE LOWER EXTREMITIES

AUTHOR(S)
Lawton, R. L.; Tidrick, R. T.; Brintnall, E. S.
PUB. DATE
April 1957
SOURCE
Angiology;Apr1957, Vol. 8 Issue 2, p161
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Studies of three adult mule patients with unilateral lower extremity changes due to diffuse, ‘capillary level,’ arteriovenous fistulization demonstrated the paradox of increased extremity blood flow and impaired tissue nutrition. The small size, diffuseness and multiplicity of the fistulae were clearly demonstrated by the plastic injection and corrosion technique and by histologic study of the two amputated legs. Surgical treatment of the fistulization was contra-indicated in one patient because serious concurrent disease outweighed the leg disorder in importance. Leg amputation was performed in the other two patients because of progressive ischemic damage to tissues of the extremities, significant cardiac overload, and because arterial and venous ligations afforded no belief. Amputation relieved intractable pain and reduced cardiac output. Non-operative treatment and operative treatment other than amputation are ineffective in diffuse ‘capillary level’ fistulization. Before amputation is advised, the diagnosis must be certain and the indications sufficient. Local changes provide an indication if they are of such severity as to approach the limits of tolerability. Increased cardiac output, in itself, may not be an indication for amputation unless there is evidence of heart strain or failure.
ACCESSION #
16351565

 

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