TY - JOUR
T1 - Analysis and Classification of Postcatheterization Femoral Arteriovenous Fistulas Based on Color Doppler Examinations
AU - Middleton, William D.
AU - Robinson, Kathryn A.
N1 - Funding Information:
Figure 1 was produced by Anne Robinson, PhD, in association with InPrint at Washington University in St. Louis.
Publisher Copyright:
© 2021 American Institute of Ultrasound in Medicine.
PY - 2022/1
Y1 - 2022/1
N2 - Objective: To analyze and classify arterial supply and venous drainage of postcatheterization femoral arteriovenous fistulas (AVFs). Methods: A review of extremity Doppler reports identified 77 femoral AVFs in 75 patients. Doppler exams were reviewed retrospectively. Fistulas were classified as above or below the common femoral artery bifurcation and subclassified based on the location of arterial inflow and venous outflow. Results: Arterial inflow originated above the femoral bifurcation in 32 cases. The communication was between the common femoral artery and the superficial circumflex iliac vein in 25 of 32 cases and between a branch of the common femoral or external iliac artery and the common femoral or external iliac vein in 4 of 32 cases. In 3 of 32 cases, AVFs arose from the common femoral artery, but the venous outflow was not determined. Arterial inflow originated from the superficial femoral artery in 23 cases. Venous outflow originated from the common femoral vein in 10 of 23 cases, the femoral vein in 7 of 23 cases, and the lateral circumflex femoral vein in 6 of 23 cases. Arterial inflow originated from the deep femoral artery in 12 cases. Venous outflow originated from the common femoral vein in 6 of 12 cases and from the lateral circumflex femoral vein 6 of 12 cases. In 8 cases, the AVF originated below the bifurcation, but the arterial inflow was not classified. In 2 cases, it was impossible to determine if the AVF originated above or below the bifurcation. Conclusions: Iatrogenic femoral AVFs arise above the femoral bifurcation more often than previously recognized. Classification based on the arterial inflow and venous outflow provides a straightforward means of describing these fistulas.
AB - Objective: To analyze and classify arterial supply and venous drainage of postcatheterization femoral arteriovenous fistulas (AVFs). Methods: A review of extremity Doppler reports identified 77 femoral AVFs in 75 patients. Doppler exams were reviewed retrospectively. Fistulas were classified as above or below the common femoral artery bifurcation and subclassified based on the location of arterial inflow and venous outflow. Results: Arterial inflow originated above the femoral bifurcation in 32 cases. The communication was between the common femoral artery and the superficial circumflex iliac vein in 25 of 32 cases and between a branch of the common femoral or external iliac artery and the common femoral or external iliac vein in 4 of 32 cases. In 3 of 32 cases, AVFs arose from the common femoral artery, but the venous outflow was not determined. Arterial inflow originated from the superficial femoral artery in 23 cases. Venous outflow originated from the common femoral vein in 10 of 23 cases, the femoral vein in 7 of 23 cases, and the lateral circumflex femoral vein in 6 of 23 cases. Arterial inflow originated from the deep femoral artery in 12 cases. Venous outflow originated from the common femoral vein in 6 of 12 cases and from the lateral circumflex femoral vein 6 of 12 cases. In 8 cases, the AVF originated below the bifurcation, but the arterial inflow was not classified. In 2 cases, it was impossible to determine if the AVF originated above or below the bifurcation. Conclusions: Iatrogenic femoral AVFs arise above the femoral bifurcation more often than previously recognized. Classification based on the arterial inflow and venous outflow provides a straightforward means of describing these fistulas.
KW - classification femoral arteriovenous fistula
KW - complications femoral catheterization
KW - femoral arteriovenous fistula
KW - iatrogenic arteriovenous fistula
KW - postcatheterization arteriovenous fistula
UR - http://www.scopus.com/inward/record.url?scp=85102437920&partnerID=8YFLogxK
U2 - 10.1002/jum.15696
DO - 10.1002/jum.15696
M3 - Article
C2 - 33720458
AN - SCOPUS:85102437920
SN - 0278-4297
VL - 41
SP - 207
EP - 216
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 1
ER -