[Lowering peripheral vascular resistance by distal arteriovenous fistula surgery. Clinical and experimental studies].

Vascular run off has an important influence on patency rates of infrapopliteal bypasses especially when prosthetic grafts are used. Construction of a distal arteriovenous fistula can improve volume and velocity of graft flow. 39 patients, 14 of them diabetic, had femoro-crural PTFE-bypasses. A distal arteriovenous fistula in common ostium technique was established in 20 cases. The patency rate (early occlusions) was improved, especially diabetic patients seemed to profit by lowering the peripheral outflow resistance, which was measured intraoperatively. The influence of arteriovenous fistulas of different calibre on bypass flow and perfusion was analysed in a circulation model.