Thanks for the post Marc!
It would be important to understand the mechanism of thrombosis ( related or not related to AVF)!
Is it Acute or subacute?
Thanks

Marc,
The ones (Mega AVF post ligation or disproportionate band-vein size, leading to fistula thrombosis…) that I have seen, had arteriogram proven hypervascularization/“hyperemia” to the FA/ hand with significant edema/congestion clinically (along with pain) that lasts <24hrs with arm elevation… hand is warm by exam etc. it seems to be related to sudden increase in the blood flow distal to the original fistula anastomosis often with poor or poorly accommodating venous system.
I have not seen an associated brachial artery thrombosis in those cases…

Thanks for your comment, which seems to address immediate consequences - I too have seen early swelling and pain as the arterial flow suddenly is deprived of a low resistence outflow, and "has nowhere to go" other than the soft tissues of the arm. I have also seem impressive systemic hypertension in the recovery room when the heart doesn't realize that it no longer has to pump 8 liters a minute. This is commonly treated with labetolol and hydralazyne, potentially making it worse, but I have argued for pure beta-blockers instead.
The arterial thrombosis is a late complication manifesting months after the operation.

The real problem is prevention with small anastomosis et the time of fistula creation!

Later, it is difficult with the probability of painfull thrombosis of the artery.

I try if possible, to reduce the flow, that diminish the risk, and I give however anticoagulant even like lmwh for one month.

In case of thrombosis, I never saw real ischemia. In one case, I had to bypass the mega artery with a venous graft from the subclavian artery to the end of the brachial artery, and to ligate the artery. The segments easy to retrieve were retrieved.