Vasc Spec Int.  2014 Jun;30(2):62-67. 10.5758/vsi.2014.30.2.62.

Central Transposition of the Cephalic Vein in Patients with Brachiocephalic Arteriovenous Fistula and Cephalic Arch Stenosis

• Jang J
• Jung H
• Cho J
• Kim J
• Kim HK
• Huh S

• KMID: 1803147
• DOI: http://doi.org/10.5758/vsi.2014.30.2.62

Abstract

PURPOSE
Our study aims to evaluate to evaluate clinical outcomes after cephalic vein transposition (CVT) to the axilla in patients with brachiocephalic arteriovenous fistula (BC-AVF) and cephalic arch stenosis (CAS).
MATERIALS AND METHODS
Hospital records of 13 patients (median age, 61 years; males, 54%) who received CVT to the proximal basilic/axillary vein due to either dysfunction (n=2) or thrombosis (n=11) between January 2010 and February 2014 were retrospectively reviewed.
RESULTS
Operation was performed under local anesthesia in all cases. There was no technical failure. Concomitant inflow procedure (banding or aneurysmorrhaphy) was performed in 5 patients (38%). During follow-up (1 to 50 months, median 17 months), 3 patients died with functioning AVF and one was successfully transplanted. Two patients suffered from recurrent symptomatic stenosis of AVF and received percutaneous balloon angioplasty. Another 2 patients experienced AVF occlusion treated with interposition graft and manual fragmentation. Overall primary, assisted primary, and secondary patency rates were 77.5%, 92.3%, and 100% at 6 months and 66.1%, 92.3%, and 100% at 1 year, respectively.
CONCLUSION
Although most patients presented with BC-AVF occlusion, technical success and access patency rates after CVT were favorable compared with historical data for interventional treatment. CVT should be considered as an appropriate option in selected patients with CAS.

Keyword

Cephalic; Stenosis; Renal dialysis; Arteriovenous fistula; Transposition

MeSH Terms

Anesthesia, Local
Angioplasty, Balloon
Arteriovenous Fistula*
Axilla
Constriction, Pathologic*
Follow-Up Studies
Hospital Records
Humans
Male
Renal Dialysis
Retrospective Studies
Thrombosis
Transplants
Veins*