title: Excellent performance of one-stage brachial-basilic arteriovenous fistula.
abstract: BACKGROUND
  According to the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) and the European Guidelines, the first and second choice for vascular access for haemodialysis are the radial-cephalic and brachial-cephalic arteriovenous fistula (AVF). Autogenous fistulas have a longer functional lifetime, less thrombotic complications and a lower infection risk compared with prosthetic implants. If it is impossible to create a brachial-cephalic AVF or after failure, either a brachial-basilic (BB) or a prosthetic forearm loop AVF may be considered. To determine the outcome of BB-AVFs, we retrospectively surveyed the results of this type of vascular access.
  
  
  METHODS
  All BB-AVF patient records over a 6 year period were subtracted from an academic hospital registry. Primary failure and primary, assisted primary and secondary patency rates were calculated with the Kaplan-Meier method. Sex, diabetes mellitus (DM), pre-operative duplex diameters, complications and interventions were recorded and correlated with the patency rates.
  
  
  RESULTS
  A total of 31 BB-AVFs were created in a one-stage surgical procedure. Of the patients, 36% were male and 19% had DM. Only one patient had a primary failure, leaving 30 (97%) of the BB-AVFs functional for dialysis treatment. Four patients died within 1 year after the operation, one of them from a catheter sepsis. Primary, assisted primary and secondary patency rates after 1 year were, 58, 83 and 90%, respectively. Patient characteristics and pre-operative duplex parameters did not influence patency rates.
  
  
  CONCLUSIONS
  The BB-AVF is an excellent third choice option for vascular access.
authors: Department of Surgery, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. xha.keuter@ah.unimaas.nl
authors: Xavier H A
authors: XH
authors: Keuter
authors: Frank M
authors: FM
authors: van der Sande
authors: Alfons G
authors: AG
authors: Kessels
authors: Michiel W
authors: MW
authors: de Haan
authors: Arnold P G
authors: AP
authors: Hoeks
authors: Jan H M
authors: JH
authors: Tordoir
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001488:Basilar Artery; D001916:Brachial Artery; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014654:Vascular Patency