Long-term outcomes of brachiobasilic transposition fistula for haemodialysis.
OBJECTIVE
The transposed basilic vein to brachial artery arteriovenous fistula provides secondary vascular access for haemodialysis. The long-term results of such fistula are assessed in this retrospective series.


METHODS
Over a 5-year period 75 brachiobasilic transposition fistulae were performed in 74 patients. There was a median follow up of 14 months.


RESULTS
Primary patency was achieved in 69 (92%) of the fistulae, and secondary patency in 74 (99%) of the fistulae. Successful interventions included angioplasties in four, and saphenous vein interposition in one, whilst three patients had failed thrombectomies. Dialysis was performed using 69 (92%) of the fistulae while 6 (8%) were never used. Of the 75 fistulae 47 (63%) were patent at follow up. Cumulative secondary patency was 66% at 1 year, 52% at 2 years, and 43% at 3 years. Complications developed in 41 (55%), and included thrombosis, infection, stenosis, arm oedema, bleeding, steal syndrome and microaneurysm formation.


CONCLUSIONS
Brachiobasilic transposition fistulae have good long-term patency rates. The complication rate, although high, is lower than that reported for PTFE grafts. Brachiobasilic fistulae should be used in preference to PTFE grafts for secondary access.
Taghizadeh
A
A
Department of Urology and Nephrology, Guy's Hospital, Thomas Guy House, London, UK.
Dasgupta
P
P
Khan
M S
MS
Taylor
J
J
Koffman
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000379:methods*; D001367:Axillary Vein / Q000503:physiopathology / Q000601:surgery*; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology