Arteriovenous fistula using transposed basilic vein in chronic hypotensive hemodialysis patients.
OBJECTIVE
Chronic hypotension is not uncommon in uremic patients on regular hemodialysis. This subset of patients often requires multiple operations to maintain their vascular access due to frequent thrombosis and occlusion of the arteriovenous fistula. Our aims was to assess whether surgical intervention with the brachial artery-transposed basilic vein fistula is effective in chronic hypotensive hemodialysis patients.


METHODS
Fifty-four hemodialysis patients with chronic hypotension were enrolled in this study. Most ofthem were referred from local hospitals. They were 23 men and 31 women. The brachial artery-transposed basilic vein arteriovenous fistula was performed in a period of 46 months at the teaching hospital. Primary patency was defined as the length of time from the fistula creation until the development of thrombosis or a complication that required operative revision ofthe fistula. Secondary patency was defined by whether the fistula could be salvaged by revision such that blood flow was maintained.


RESULTS
There was no technical failure and none of these patients died due to the surgical operation. The primary patency rate was 89.80% at 1 year, 73.08% at 2 years, and 64.710% at 3 years. The secondary patency rate was 95.92% at 1 year, 84.62% at 2 years, and 76.47% at 3 years.


CONCLUSIONS
Brachial artery-transposed basilic vein arteriovenous fistula may present good primary alternative vascular access in chronic hypotensive hemodialysis patients.
Tsai
Y T
YT
Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Lin
S H
SH
Lee
G C
GC
Huen
G G
GG
Lin
Y F
YF
Tsai
C S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001916:Brachial Artery / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D006435:Renal Dialysis / Q000009:adverse effects; D014654:Vascular Patency