ROX Anastomotic Coupler System

[zar]

www.uclahealth.org/body.cfm?xyzpdqa...il&ref=1395

Page 5 www.pulmonarypaper.org/PP(Nov-Dec)Final.pdf

Vidios,on how it may be done(not ROX)http://www.synovismicro.com/gem_microvascular_anastomotic_coupler.php

www.interactivenetworkgroup.com/medical.html

Pathophysiology
When an arteriovenous fistula is formed involving a major artery like the abdominal aorta, it can lead to a large decrease in peripheral resistance. This lowered peripheral resistance causes the heart to increase cardiac output in order to maintain proper blood flow to all tissues. The physical manifestations of this would be a relatively normal systolic blood pressure with a decreased diastolic blood pressure resulting in a wide (large) pulse pressure. Normal blood flow in the brachial artery is 85 to 110 milliliters per minute (mL/min). After the creation of a fistula, the blood flow increases to 400 to 500 mL/min immediately, and 700 to 1,000 mL/min within 1 month. A bracheocephalic fistula above the elbow has a greater flow rate than a radiocephalic fistula at the wrist. Both the artery and the vein dilate and elongate in response to the greater blood flow and shear stress, but the vein dilates more and becomes "arterialized". In one study, the cephalic vein increased from 2.3 mm to 6.3 mm diameter after 2 months. When the vein is large enough to allow cannulation, the fistula is defined as "mature."
www.bing.com/reference/semhtml/Arte...enous%20fistula


clinicaltrials.gov/ct2/show/NCT00992680

[Blossom/Jackie W.]

Zar... You're a very brigt individual........
I'm curious....

Do you have an opinion on this by any chance? (BTW; I couldn't "connect" with the 1st feed/link.)

[John]

Sounds very interesting Zar what does it mean in my words

[zar]

www.uclahealth.org/body.cfm?xyzpdqabc=0&id=403&action=detail&ref=1395

www.ncbi.nlm.nih.gov/pubmed/20382714

Jackie,
Has you know I am not a Dr ,I dont think this would be good for people with Heart problems i.e. Causes the heart to increase cardiac output ?.
Because they are going to us a main artery,they will make sure there will be enough blood flow i.e to the legs if there was a problem?.
You can see by my 2nd link that it will act the same as someone on ambulance oxygen exercising.

John,
Think of it as a booster instead of the fuel (O2) just keeping the engine ticking over.
Some of the fuel(O2 in the blood) will not be use up,it will return to the heart,mix with some new fuel (O2),that has come from the lungs to the heart.
Then it will travel down to(legs?) so they can work harder and longer.

[maryaz]

I did some reading about this and it looked like this technique was used for various things.

I was so disappointed last Tuesday because my pulmonary rehab had someone coming in to do the class and it was about this. I really wanted to get there. I could not breath. It got so bad Monday night I just couldn't even push myself to get there. I needed to see my doctor more. I already was not excited too much.

I know I would not have qualified for the study. I fell into the obese for weight by about 1.5 and I could never do a 6 minute walk. I still wanted to see what it was about. The group of Pulmonary Drs that I go to have a few offices. They are part of this study and have been with others. I take a little more interest.

I was wondering what Zar thought. I posted about it once on CI and asked. Thanks for the input.

[zar]

www.merck.com/mmhe/sec03/ch036/ch036e.html

[Blossom/Jackie W.]

This is interesting. Especially this part.... " Walking distance did not change in patients who did not have a clinically meaningful response to oxygen at baseline. CONCLUSIONS: An ileofemoral arteriovenous fistula increased 6-minute walking distance patients with severe COPD matching the improvement seen with supplemental oxygen. An initial response to supplemental oxygen predicted a therapeutic response to the AVF."

I wonder if the benefits though really outweighs the risk.... and "how long" does it work for?

Mary; I hope you're doing better.....

[maryaz]

Thanks Zar for another link. I am not crazy about the Merck site but it will work. Merck, Work rhymes! OMG, I am overworked.

Thanks Jackie for the well wishes. I can use them.

Maybe when I go in for checkups sometimes, my pulmonary doctor will know how the study is going. Different office of doctors and different hospital but they all still same group working together.

Question Zar; Why did you not post this in the COPD section? I am still hesitant how much good it would do a COPD person if strictly for that. We will see. The ones I have been more excited about have not panned out. Maybe this will work. Still over my head but have to go read the article now.

Have a good weekend all. I am going to try to keep an eye on Chris but sometimes I just don't get over here.

[chrisw]

I do NOT claim to fully understand the theory behind this. However it appears to allow the lungs to function better (take in more O2 and get rid of more CO2) by taking advantage of a lung problem where a shortage of oxygen in the blood causes part of the lung to constrict the blood vessels and reduce the effectiveness of that part of the lung. Because a part of the blood circulating through the heart and lungs is "unused" when it goes straight from an artery to a vein (this is what a fistula does) then the blood going to the lungs has more oxygen and that part of the lung that was constricting will work better.
To me this might work in some circumstances, but with severe emphysema the number of useful alveoli drops and so does the number of blood vessels, so this is the cause of a lot of the restricted blood flow, besides which I reckon that theoxygen in the blood is really needed throughout the body and sending some back to the heart before it circulates and oxygenates ALL the body is simply a waste of good blood flow. It reeks to me of a scheme to save money on supplemental oxygen at the expense of the future life of the body. Note that this is my PERSONAL OPINION and may be worth less than the time it took for you to read it!

[John]

Thank You Zar! gotcha now it makes scence