Background: Arteriovenous fistulae impair the distal circulation, but their effects at the microcirculatory level are not well understood. This study presents the carotid-jugular fistula (CJF) as a model to evaluate fistula-related microcirculatory and systemic changes. Materials and Methods: Female Wistar rats were anesthetized and divided into a fistula group (FG, n = 10) and a sham group (SG, n = 6). End-to-end anastomosis was performed between the right carotid artery and the jugular vein in the FG. The hemodynamic status was followed for 6 weeks. On the sixth postoperative week, liver and kidney microcirculation was measured using laser Doppler; then microcirculatory changes were assessed after occlusion of the carotid artery. At the end of the experiment, histological samples were taken and the weights of the organs were measured. Results: The heart rate and systolic blood pressure decreased significantly due to the CJF. Laser Doppler showed a reduction in liver blood flow units (BFU) in the FG in comparison with the SG (p = 0.01), and they increased (p < 0.01) after occlusion of the fistula. Kidney BFU showed slight changes only. The comparative morphological study revealed significant increases in heart weight (p < 0.001) and left ventricular hypertrophy (p = 0.008) in the FG. Conclusion: Beside hemodynamic and morphologic changes, a CJF causes a deterioration in the microcirculation of the liver rather than of the kidney, but occlusion of the CJF immediately reverses these changes.

1.
Agarwal
AK
.
Systemic effects of hemodialysis access
.
Adv Chronic Kidney Dis
.
2015
Nov
;
22
(
6
):
459
65
.
[PubMed]
1548-5595
2.
Zhou
W
. Acquired Arteriovenous Fistulae. In:
Jl
C
,
Johnston
KW
, editors
.
RUTHERFORD’S Vasc. Surg. Eighth Edi
.
Philadelphia
:
Elsevier Saunders
;
2014
. pp.
1268
82
.
3.
Kang
L
,
Yamada
S
,
Hernandez
MC
,
Croatt
AJ
,
Grande
JP
,
Juncos
JP
, et al
Regional and systemic hemodynamic responses following the creation of a murine arteriovenous fistula
.
Am J Physiol Renal Physiol
.
2011
Oct
;
301
(
4
):
F845
51
.
[PubMed]
1931-857X
4.
Bos
WJ
,
Zietse
R
,
Wesseling
KH
,
Westerhof
N
.
Effects of arteriovenous fistulas on cardiac oxygen supply and demand
.
Kidney Int
.
1999
May
;
55
(
5
):
2049
53
.
[PubMed]
0085-2538
5.
Croatt
AJ
,
Grande
JP
,
Hernandez
MC
,
Ackerman
AW
,
Katusic
ZS
,
Nath
KA
.
Characterization of a model of an arteriovenous fistula in the rat: the effect of L-NAME
.
Am J Pathol
.
2010
May
;
176
(
5
):
2530
41
.
[PubMed]
0002-9440
6.
Hemodialysis Access
LM
. Nonthrombotic Complications. In:
Jl
C
,
Kw
J
, editors
.
RUTHERFORD’S Vasc. Surg. Eighth Edi
.
Philadelphia
:
Elsevier Saunders
;
2014
. pp.
1135
52
.
7.
Zanow
J
,
Kruger
U
,
Scholz
H
.
Proximalization of the arterial inflow: a new technique to treat access-related ischemia
.
J Vasc Surg
.
2006
Jun
;
43
(
6
):
1216
21
.
[PubMed]
0741-5214
8.
Lemson
MS
,
Zwiers
I
,
Kurvers
HA
,
Daemen
MA
,
Beuk
RJ
,
Tordoir
JH
.
Prosthetic Arteriovenous Fistulas for Hemodialysis Impair the Macro- and Microcirculation of the Hand More Than Brescia/Cimino AV Fistulas
.
J Vasc Technol
.
1997
;
21
:
187
91
.
9.
Gomes
AC
,
Falcão-Pires
I
,
Pires
AL
,
Brás-Silva
C
,
Leite-Moreira
AF
.
Rodent models of heart failure: an updated review
.
Heart Fail Rev
.
2013
Mar
;
18
(
2
):
219
49
.
[PubMed]
1382-4147
10.
Zheng
C
,
Zhou
Y
,
Huang
C
,
Zhang
Z
,
Liu
YI
,
Xu
Y
.
Establishment of a rat autogenous arteriovenous fistula model following 5/6 nephrectomy
.
Exp Ther Med
.
2015
Jul
;
10
(
1
):
219
24
.
[PubMed]
1792-0981
11.
Rotmans
JI
.
Animal Models for Studying Pathophysiology of Hemodialysis Access
.
Open Urol Nephrol J
.
2014
;
7
(
1
):
14
21
. 1874-303X
12.
Morgan
MK
,
Anderson
RE
,
Sundt
TM
 Jr
.
A model of the pathophysiology of cerebral arteriovenous malformations by a carotid-jugular fistula in the rat
.
Brain Res
.
1989
Sep
;
496
(
1-2
):
241
50
.
[PubMed]
0006-8993
13.
Yang
ST
,
Rodriguez-Hernandez
A
,
Walker
EJ
,
Young
WL
,
Su
H
,
Lawton
MT
.
Adult mouse venous hypertension model: common carotid artery to external jugular vein anastomosis
.
J Vis Exp
.
2015
Jan
;
50472
(
95
):
50472
.
[PubMed]
1940-087X
14.
Nasir
S
,
Aydin
MA
,
Karahan
N
,
Demiryürek
D
,
Sargon
M
.
New microvenous anastomosis model for microsurgical training: external jugular vein
.
J Reconstr Microsurg
.
2006
Nov
;
22
(
8
):
625
30
.
[PubMed]
0743-684X
15.
Velez-Roa
S
,
Neubauer
J
,
Wissing
M
,
Porta
A
,
Somers
VK
,
Unger
P
, et al
Acute arterio-venous fistula occlusion decreases sympathetic activity and improves baroreflex control in kidney transplanted patients
.
Nephrol Dial Transplant
.
2004
Jun
;
19
(
6
):
1606
12
.
[PubMed]
0931-0509
16.
Wang
X
,
Ren
B
,
Liu
S
,
Sentex
E
,
Tappia
PS
,
Dhalla
NS
.
Characterization of cardiac hypertrophy and heart failure due to volume overload in the rat
.
J Appl Physiol (1985)
.
2003
Feb
;
94
(
2
):
752
63
.
[PubMed]
8750-7587
17.
Garcia
JH
,
Wagner
S
,
Liu
KF
,
Hu
XJ
.
Neurological deficit and extent of neuronal necrosis attributable to middle cerebral artery occlusion in rats. Statistical validation
.
Stroke
.
1995
Apr
;
26
(
4
):
627
34
.
[PubMed]
0039-2499
18.
Tohda
K
,
Masuda
H
,
Kawamura
K
,
Shozawa
T
.
Difference in dilatation between endothelium-preserved and -desquamated segments in the flow-loaded rat common carotid artery
.
Arterioscler Thromb
.
1992
Apr
;
12
(
4
):
519
28
.
[PubMed]
1049-8834
19.
Sageshima
M
,
Kawamura
K
,
Toda
K
,
Masuda
H
,
Shozawa
T
.
An ultrastructural study of pulmonary capillary vessels in blood volume-overloaded rat
.
Adv Exp Med Biol
.
1990
;
277
:
673
80
.
[PubMed]
0065-2598
20.
Geenen
IL
,
Kolk
FF
,
Molin
DG
,
Wagenaar
A
,
Compeer
MG
,
Tordoir
JH
, et al
Nitric Oxide Resistance Reduces Arteriovenous Fistula Maturation in Chronic Kidney Disease in Rats
.
PLoS One
.
2016
Jan
;
11
(
1
):
e0146212
.
[PubMed]
1932-6203
21.
Chou
TF
,
Chen
YS
,
Yu
CC
,
Chien
CT
,
Chen
CF
.
Simple methods to elevate pulmonary arterial pressure by pre- and post-tricuspid shunts in rats
.
Chin J Physiol
.
2002
Sep
;
45
(
3
):
131
5
.
[PubMed]
0304-4920
22.
Liu
Z
,
Hilbelink
DR
,
Crockett
WB
,
Gerdes
AM
.
Regional changes in hemodynamics and cardiac myocyte size in rats with aortocaval fistulas. 1. Developing and established hypertrophy
.
Circ Res
.
1991
Jul
;
69
(
1
):
52
8
.
[PubMed]
0009-7330
23.
Ozek
C
,
Zhang
F
,
Lineaweaver
WC
,
Chin
BT
,
Eiman
T
,
Newlin
L
, et al
A new heart failure model in rat by an end-to-side femoral vessel anastomosis
.
Cardiovasc Res
.
1998
Jan
;
37
(
1
):
236
8
.
[PubMed]
0008-6363
24.
Langer
S
,
Heiss
C
,
Paulus
N
,
Bektas
N
,
Mommertz
G
,
Rowinska
Z
, et al;
European Vascular Center Aachen-Maastricht
.
Functional and structural response of arterialized femoral veins in a rodent AV fistula model
.
Nephrol Dial Transplant
.
2009
Jul
;
24
(
7
):
2201
6
.
[PubMed]
0931-0509
25.
Hever
T
,
Nemeth
N
,
Brath
E
,
Toth
L
,
Kiss
F
,
Sajtos
E
, et al
Morphological, hemodynamical and hemorheological changes of mature artificial saphenous arterio-venous shunts in the rat model
.
Microsurgery
.
2010
Nov
;
30
(
8
):
649
56
.
[PubMed]
0738-1085
26.
Langenickel
T
,
Pagel
I
,
Höhnel
K
,
Dietz
R
,
Willenbrock
R
.
Differential regulation of cardiac ANP and BNP mRNA in different stages of experimental heart failure
.
Am J Physiol Heart Circ Physiol
.
2000
May
;
278
(
5
):
H1500
6
.
[PubMed]
0363-6135
27.
Aalbers
MW
,
Rijkers
K
,
van Winden
LA
,
Hoogland
G
,
Vles
JS
,
Majoie
HJ
.
Horner’s syndrome: a complication of experimental carotid artery surgery in rats
.
Auton Neurosci
.
2009
May
;
147
(
1-2
):
64
9
.
[PubMed]
1566-0702
28.
Treskatsch
S
,
Feldheiser
A
,
Rosin
AT
,
Sifringer
M
,
Habazettl
H
,
Mousa
SA
, et al
A modified approach to induce predictable congestive heart failure by volume overload in rats
.
PLoS One
.
2014
Jan
;
9
(
1
):
e87531
.
[PubMed]
1932-6203
29.
Huang
M
,
Hester
RL
,
Guyton
AC
.
Hemodynamic changes in rats after opening an arteriovenous fistula
.
Am J Physiol
.
1992
Mar
;
262
(
3 Pt 2
):
H846
51
.
[PubMed]
0002-9513
30.
Flaim
SF
,
Minteer
WJ
,
Nellis
SH
,
Clark
DP
.
Chronic arteriovenous shunt: evaluation of a model for heart failure in rat
.
Am J Physiol
.
1979
May
;
236
(
5
):
H698
704
.
[PubMed]
0002-9513
31.
Obeid
AN
,
Barnett
NJ
,
Dougherty
G
,
Ward
G
.
A critical review of laser Doppler flowmetry
.
J Med Eng Technol
.
1990
Sep-Oct
;
14
(
5
):
178
81
.
[PubMed]
0309-1902
32.
Huang
M
,
LeBlanc
MH
,
Hester
RL
.
Evaluation of the needle technique for producing an arteriovenous fistula
.
J Appl Physiol (1985)
.
1994
Dec
;
77
(
6
):
2907
11
.
[PubMed]
8750-7587
33.
Brower
GL
,
Janicki
JS
.
Contribution of ventricular remodeling to pathogenesis of heart failure in rats.
Am J Physiol - Hear Circ Physiol
2001
;280:674–83.
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