title: Determinants of failure of brachiocephalic elbow fistulas for haemodialysis.
abstract: OBJECTIVE
  The aim of this study was to analyse the results of brachiocephalic fistulas for haemodialysis and to determine possible predictors of failure.
  
  
  METHODS
  Between April 1999 and September 2004, a consecutive series of 100 autologous brachiocephalic fistulas were created in 96 patients. There were 57 men and 39 women with a mean (SD) age of 59.2 (15.6) years. Data were prospectively gathered.
  
  
  RESULTS
  The mean (SD) follow-up was 20.1 (16.4) months. The primary, primary assisted, and secondary patency rates after 6 months were 73.4, 83.2 and 86.4%, respectively. After 1 year, these figures were 54.7, 72.3 and 79.2%, and after 2 years 40.4, 59.2 and 67.5%, respectively. Predictors of failure with regard to primary patency, determined with Cox regression multivariate analysis, included diabetes mellitus (HR 2.81, p < 0.001) and a history of contralateral PTFE loop graft (HR 7.79, p = 0.007).
  
  
  CONCLUSIONS
  Primary patency of brachiocephalic fistulas is comparable to that of radiocephalic fistulas. Primary assisted and secondary patency rates can, however, be brought to a much higher level, especially in patients without diabetes and a large-diameter venous outflow tract.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. czeebregts@hotmail.com
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: I F J
authors.initials: IF
authors.lastname: Tielliu
authors.forename: R G
authors.initials: RG
authors.lastname: Hulsebos
authors.forename: C
authors.initials: C
authors.lastname: de Bruin
authors.forename: E L G
authors.initials: EL
authors.lastname: Verhoeven
authors.forename: R M
authors.initials: RM
authors.lastname: Huisman
authors.forename: J J A M
authors.initials: JJ
authors.lastname: van den Dungen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D016122:Brachiocephalic Trunk / Q000601:surgery*; D016121:Brachiocephalic Veins / Q000601:surgery*; D004550:Elbow / Q000098:blood supply / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000628:therapy*; D012307:Risk Factors; D017211:Treatment Failure; D014654:Vascular Patency