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To rescue severely affected hind limbs from amputation, the surgery of the distal vein arterialization DVA technique has been used and refined in respect of different theoretical and pathophysiological aspects; tissue cylinder model, total venular length, oxygen diffusion to muscles, water movements are discussed under the surgically introduced unusual circumstances. All these variables are interrelated to support the fundamental oxygen utilization of muscle tissues to survive. Separately carried out studies and techniques are summarized here. The therapeutic results of DVA surgery were compared with angiogenic and pharmacological treatments in respect of peripheral arterial disease.Key words: peripheral arterial disease, distal vein arterialization, tissue cylinder model, oxygen diffusion, angiogenetic treatment, pharmacological treatment
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