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Emergency Surgery of Acute Traumatic Arteriovenous Fistulas

Nenad Ilijevski, Djordje Radak, Bozina Radević, Milovan Bojić, Goran Kronja, Sidor Mišović · Cardiovascular Surgery · 2000

The purpose of this report was to analyze the clinical presentation, diagnosis, surgical and non-surgical treatment and the outcome of patients with acute AVFs seen during the last 8 years. During 1991–98 we treated 47 patients with traumatic AVFs. Among these patients 11 were classified as ‘acute’ AVF. All the patients were male and they ranged in age from 17 to 64 yr (mean 25 yr). The time from injury to admission to our two institutions varied from 4 h to 17 days. Emergency surgery was performed in unstable patients and in those with an expanding haematoma based on clinical assessment alone. The acute surgery group consisted of stable patients that were operated after angiography examination. A machinery murmur and thrill were present in seven patients, and peripheral pulses were absent in four patients. The main blood vessels were reconstructed using various techniques in eight patients and minor blood vessel were ligated in three patients. Two lower limb amputations had to be performed, both after reconstruction of popliteal AVFs. In the remaining nine patients reconstruction of the axial vessels was successful and no signs of ischemia developed in patients after ligation of

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