Morphological and functional features of different types of arteriovenous anastomoses in rabbits
V.O. Voronych, O.Ya. Popadiuk, O.H. Popadynets, T.L. Kotyk
- Ivano-Frankivsk National Medical University, Ukraine
DOI: https://doi.org/10.15407/fz71.03.018

Abstract
The effectiveness of programmed haemodialysis in patients with chronic kidney disease depends on the for -
mation of permanent vascular access. The morphofunctional characteristics of arteriovenous anastomoses
were studied in rabbits, where in the first group the “end to the side” was between the common carotid
artery and the external jugular vein, and in the second group the “end to the side” was made using jugular
vein tributaries, where the “side” of the anastomosis was formed by the common carotid artery and the
“end” by the maxillary and glossofacial veins. Morphological and functional features of the vessels were
studied using ultrasound and histological methods. Ultrasound examination of vessels was performed after
2 h and on the 30th day after anastomosis formation (“Philips Lumify”, USA, with a linear transducer of
4-12 MHz). Animals were withdrawn from the experiment on the 30th day of observation. It was found that
after one month, the diameter of the common carotid artery exceeded the value in intact animals (control
group) by 44% (only in rabbits of the 2nd group), the external jugular vein by 2.4 and 2.6 times in ani-
mals of the 1st and 2nd groups, respectively. Blood flow velocity in the external jugular vein in the early
postoperative period increased by 4.7 and 5.1 times, on the 30th day, by 7.2 and 7.9 times, in animals of
the 1st and 2nd groups, respectively. According to the results of light microscopy, in animals of 1st group,
the middle layer of the vascular wall is represented by disorganised bundles of smooth myocytes, and ar-
eas of their hyperplasia are noticeable. In the venous wall, stasis in the blood vessels of its middle layer,
lymphocytic infiltration, and islands of adipocyte accumulation are detected. In animals of the 2nd group,
the inner, middle, and outer membranes are identified in the anastomosis area, and endothelial cell nuclei
are visualised along the perimeter of the lumen. Smooth myocytes of the middle layer are surrounded by a
network of collagen and elastic fibres. In the vein wall, the middle membrane is thickened, smooth myocytes
and adipocytes of different calibres are visualised. Thus, the arteriovenous anastomosis end-to-side leads
to a significant increase in blood flow and vascular dilatation, and the use of venous tributaries in the for -
mation of vascular access contributes to more effective structural restructuring and fistula functionality.
Keywords:
arteriovenous fistula; configuration of vascular anastomoses; structural features; functional changes; haemodynamics
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