Free-flap distal arteriovenous fistula: when to close it?
Hage JJ, Monstrey S.
Department of Plastic Surgery, Academisch Ziekenhuis Vrije
Universiteit, Amsterdam, The Netherlands.
Abstract [Full Text] [PDF]
A distal arteriovenous fistula was created secondarily in an innervated radial forearm free flap, to salvage the neophallus in three female-to-male transsexuals.
This resulted in permanent edema and an arterial thrill in the neophallus. The arteriovenous fistulas were closed after 6 weeks to 20 months. Acute endothelial damage with risk of thrombosis, due to ischemia and exposure to arterial blood pressure, may be expected to have been repaired 4 to 6 weeks after arterialization of the veins. Intimal thickening will have started by then, but a subsequent decrease in vascular luminal diameter may still be expected to be reversible.
The authors conclude that ligation of the distal arteriovenous fistula may safely be performed some 6 weeks after the salvage procedure.
Citation: J Reconstr Microsurg 1998 Aug;14(6):407-10 an article published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>