Indications to the formation of arteriovenous fistulas in performing reconstructive operations in patients with atherosclerotic lesions of the main arteries of the femur and shin at the stage of critical ischemia

: Causes of early shunt thromboses were studied retrospectively in 35 patients with occlusion of the femoro-popliteal segment and critical ischemia, in whom the operation of distal femoro-tibial shunt with the autovein had been performed by the method in situ without an application of the arteio-venous fistula (AVF). Early thromboses of the shunts took place in 8 patients (22.9%). The main cause of the early thromboses of the femorotibial shunts was shown to be a critical occlusive-stenotic lesion of the main arteries of the shin and foot with dysfunction of the plantar arch as well as decompensation of the microcirculation system. Objective criteria of the formation of AVF were worked out. The application of the criteria in operative treatment of 25 patients allowed the number of early thromboses to be reduced to 4%.