Vasc Spec Int.  2016 Jun;32(2):51-56. 10.5758/vsi.2016.32.2.51.

Upper Arm Basilic Vein Transposition for Hemodialysis: A Single Center Study for 300 Cases

• Lee Y
• Song D
• Kim MJ
• Yun SC

• KMID: 2328032
• DOI: http://doi.org/10.5758/vsi.2016.32.2.51

Abstract

PURPOSE
The population of end-stage renal failure patients dependent on hemodialysis continues to expand with an increasing number of patients having an unsuitable cephalic vein or failed radio- and brachio-cephalic fistula. In these patients, the transposed basilic vein to brachial artery arteriovenous fistula (BaVT) provides autologous choice for hemodialysis. The results of basilic vein transposition arteriovenous fistula were assessed.
MATERIALS AND METHODS
Three hundred cases of BaVT performed at a single center during the period of January 2005 to December 2011 were reviewed retrospectively. Data including demographics and postoperative complications were collected. Primary and secondary patency rates were determined by using Kaplan-Meier methods.
RESULTS
The median age of patients was 57.4±13.1 years, and 154 patients were male. Renal failure was associated with hypertension in 88.7%, and with diabetes in 34.0%. The mean follow-up was 27.4±20.0 (12 to 72) months. There was no operation-related death. Eighteen patients required prosthetic graft interposition because of short vein. Thirty-five postoperative complications developed in 41 patients (148 cases), including thrombosis, stenosis, hematoma, seroma, arm swelling, steal syndrome, infection and aneurysm formation. Primary patency of BaVT was 69%, 60%, 53%, 52%, 44%, and 22% at 1, 2, 3, 4, 5, and 6 years, respectively. Secondary patency was 99%, 97%, 97%, 97%, 95%, and 95%, respectively.
CONCLUSION
Chronic renal failure patients with hemodialysis may benefit from BaVT, because of high patency, less radiologic procedure, and less infection rate. The BaVT fistula should be used in preference to polytetrafluoroethylene grafts for secondary access.

Keyword

Arteriovenous fistula; Basilic vein; Renal dialysis

MeSH Terms

Aneurysm
Arm*
Arteriovenous Fistula
Brachial Artery
Constriction, Pathologic
Demography
Fistula
Follow-Up Studies
Hematoma
Humans
Hypertension
Kidney Failure, Chronic
Male
Ocimum basilicum*
Polytetrafluoroethylene
Postoperative Complications
Renal Dialysis*
Renal Insufficiency
Retrospective Studies
Seroma
Thrombosis
Transplants
Veins*
Polytetrafluoroethylene